Frailty Rapid Assessment and Treatment

Rapid Assessment and Triage (RAT) is the assessment of ‘majors’ type patients in the Emergency Department. Frailty expertise early in a patient journey ensures timely assessment and can reduce hospital length of stay. 
On 11 non-consecutive days in March 2026, 8-5pm, a Frailty ACP was located in RAT in our type 1 Emergency Department. Patients were included if aged ≥75 years with a CFS score of ≥5 presenting with a frailly syndrome. Exclusion criteria included patients with trauma, potential long bone injuries or surgical presentations. After RAT by either a Frailty ACP or ED, patients were either streamed directly to frailty for further assessment and admission or remained under the care of the emergency department and followed standard pathways. Outcome measures included length of stay, time to assessment by a competent decision maker and time to assessment by an expert decision maker.
77 patients met the inclusion criteria. Mean age was 86.6 years and mean CFS score was 6. 35 patients underwent Frailty RAT Vs 42 standard care. 20% of patients resided in a care home. The 7 day readmission rate was 6.5% and 15.6% 30 day readmission rate for all patients
Patients who were admitted under frailty had a reduced LoS if they underwent Frailty RAT (6 days) Vs ED RAT (6.5 days). This was also shorter when compared with average departmental length of stay (8 days).
Time to first assessment was improved (4hr 30mins) compared to baseline data (9hrs). Time to Consultant review was also improved (9hr 40mins) compared to baseline data (15hr 30mins). 
Quality Improvement Methodology identified strong MDT collaboration within the emergency department and positive patient feedback on communication and care. 
The impact of a Frailty ACP in RAT impacted positively on patient flow and MDT working. Our conclusions are limited by the small sample size.