Improving Clinical Frailty Score Documentation in Oncology Wards

Introduction

The Clinical Frailty Score (CFS) allows appropriate frailty assessment to guide management plans for oncology patients. CFS documentation is not standard at our trust. We aimed to introduce CFS documentation in the Acute Oncology Service (AOS) clerking proforma and evaluate its use in patients aged >65 to help guide management.

Methods

Data was obtained from inpatients on the oncology wards via NerveCentre. Three PDSA cycles were completed:

• Cycle 1: An evaluation to identify how many patients had a documented CFS. Based on this, a poster was created, emailed to oncology staff, and displayed around the ward.
• Cycle 2: A teaching presentation was delivered to junior doctors on the oncology ward.
• Cycle 3: Nursing staff were informed and encouraged to discuss CFS during morning board rounds.

Data was collected after each cycle.

Results

There was a total increase of 20% in documentation after all three interventions. The initial documentation rate was 4.4%. This rose to 6.6% after posters were introduced, increased to 15.5% following junior doctor teaching, and reached 24.4% after involving nursing staff in PDSA Cycle 3.

Conclusion

Educating junior doctors and involving nurses in discussions around CFS helped improve documentation. It has been noted that identifying the CFS on admission increases the likelihood of it being recorded. Since the improvement is still modest, we now plan to incorporate the CFS into the AOS clerking proforma to increase compliance and make documentation part of routine practice.