Abstract
Key words: acute frailty, triple assessment, comprehensive geriatric assessment, integrated discharge team (IDT)
Introduction: The expansion of acute frailty services is essential to meet the needs of our ageing population. According to the UK Office for National Statistics 2021 census, over one-sixth of the population (18.6%, or 11.1 million people) were aged 65 and over, with this proportion expected to rise to 25% within the next 20 years.
British Geriatrics Society emphasizes the importance of using these metrics early in the patient journey, particularly for those with high 4AT, CFS, or NEWS scores. These patients
should not be left in corridor spaces, therefore AFT at Newcastle upon Tyne was introduced to aid admission and discharge planning.
Methods: Data was collected from 27th–31st January 2025 on patients referred to the AFT. A traffic light system was used for analysis: green for assessments completed by AFT, amber for completion within 72 hours of admission, and red for incomplete assessments. Audited areas included CFS, 4AT, NEWS, collateral history, medication and falls reviews, medical and functional assessments, discharge planning, onward referrals, and admission/discharge status.
Results: 28 patients reviewed.
CFS completed by AFT=14, ED=11, not documented=3. 4AT completed by AFT=22, not documented=6. NEWS<4, all patients (score 0=5, score 1=1, score 2=11, score 3=6, score 4=1. Collateral history from AFT=19, ED/AS=5, not completed=3. Medication review AFT=16, AS/ED=4, not completed=8. Falls review of medication AFT=16, not completed=12. Medical assessment AFT=16, ED/AS=12. Functional assessment AFT=21, AS=1, not completed=6. Discharge plans, yes=17, no=11. Discharged=9, straight BOH=11, admitted=8.
Conclusion: By improving the consistency of CFS documentation in ED, enhancing falls medications reviews, as well as standardising functional assessments, we can refine how elderly patients are triaged and managed. While we cannot directly link a CFS of 6 to pathway modifications, the data suggests that a more structured triple assessment can avoid admissions to assessment suite and minimising time spent in the ED. Future training efforts should focus on embedding the triple assessment into routine practice, ultimately optimising patient flow, improving care outcomes.