From Corridor to Care: Decompressing the ED Through Proactive Frailty Transfers to FSDEC

Introduction: Corridor care disproportionately affects patients living with frailty and has become a growing challenge within our Emergency Department (ED). It is widely acknowledged to be unsafe, undignified and unacceptable. To improve patient flow and reduce corridor care, we sought to better utilise our Frailty Same Day Emergency Care (FSDEC) unit by proactively identifying suitable patients for early transfer. At the time of the project, FSDEC operated Monday–Friday, 9am–5pm, with medical and nursing support but no dedicated therapy input. 

Methods: Awareness of FSDEC was increased through education, posters and verbal promotion within the ED. FSDEC clinicians established a daily presence in the ED, reviewing potentially suitable patients, discussing cases with the multidisciplinary team, and actively transferring (“pulling”) appropriate patients into FSDEC. ED staff were also encouraged to identify suitable patients using a designated “streaming” marker within the electronic patient record. 

Results: In the three months before the intervention, 26 patients were transferred from ED to FSDEC (November - 7, December - 8, January - 11). During the three-month pilot period, transfers increased to 46 patients (February - 22, March - 14, April - 8), representing a 77% increase. Admissions remained unchanged at two patients in both periods, suggesting appropriate patient selection. Despite senior ED support, use of the electronic streaming marker remained low. 

Conclusion: A proactive FSDEC presence within the ED substantially increased transfers of frail patients from corridor-based care to a more appropriate frailty-focused environment. Patient received timely specialist intervention, and reduced time spent in the ED corridor. Active case-finding was more effective than relying on ED teams alone to identify suitable patients, while also improving awareness, visibility and access to frailty expertise. Expanding multidisciplinary support and service hours may further enhance the impact of FSDEC on patient flow and corridor care.