Frailty Assessment & Needs in Older Adults with Myeloma
Background & Aim We present findings from a joint Geriatrician and Haematologist Myeloma clinic pilot, specifically a) frailty needs of the cohort and b) performance of frailty screening tools including International Myeloma Working Group Frailty Index (IMWG-FI, Performance Status (PS), Geriatric 8 (G8), Clinical Frailty Score (CFS) and Edmonton Frail Scale (EFS), against expert opinion of frailty. Methods During pre-clinic MDM, patients were flagged for Geriatrician review following concern from either Geriatrician or Haematologist. This review was used to benchmark the presence of frailty by
Evaluation of Heidi AI Scribing Technology in Improving Efficiency and Documentation Quality in Frailty Services
Introduction: Traditional clinical documentation methods were time-consuming and prone to inconsistency within the Frailty Team at City Health Care Partnership (CHCP), affecting productivity across workstreams including Urgent Community Response (UCR) and Comprehensive Geriatric Assessment (CGA). Heidi, an AI scribe developed by Heidi Health UK, generates clinical notes and structured care plans by interpreting patient-clinician discussions, reducing administrative burden and improving note quality. Methods: York Health Economics Consortium (YHEC) conducted a mixed-methods evaluation of Heidi
Improving multidisciplinary team working: Phase 2 of a quality improvement project in a tertiary care university hospital
Introduction The Multi-disciplinary team meeting (MDM) underpins geriatric medicine. The previously-described first phase of this project addressed variations in MDM frequency and practice across Healthcare of Older People (HCOP) wards. This second phase built on those changes with the aim of improving three key areas; process, values and skills. efficiency / effectiveness of meetings (process) team-working (values) empowering of individuals (skills) quality of the documentation (skills) Methods A previous survey of MDT members on 2 HCOP wards identified areas of focus and suggestions for
Association Between Frailty and Incident Urinary Incontinence in Older Adults: An Updated Systematic Review and Meta-Analysis
Improving Delirium Screening in Older Adults Presenting to the Emergency Assessment Unit (EAU), Horton Hospital
Introduction Delirium is a common, serious, and often under-recognised condition in older hospitalised adults. Early identification and management of reversible causes can reduce associated morbidity, mortality, length of stay, and long-term cognitive decline. The 4AT is a validated delirium screening tool recommended for acute hospital settings; however, completion rates in the Emergency Assessment Unit (EAU) were perceived to be low. This project aimed to improve delirium screening and detection in patients aged 65 years and over presenting to the EAU at Horton Hospital. Method All patients
Impact of delirium and dementia on 30-day readmission to hospital by place of residence in older adults: ORCHARD-EPR cohort
Prevalence and outcomes of physical frailty by cognitive status in older people with emergency hospitalisation in ORCHARD-EPR
Distinct Clinical Phenotypes of Long COVID: Autonomic vs Inflammatory Presentations in Younger and Older Adults.
Introduction While Post-Acute Sequelae of SARS-CoV-2 (PASC) is a recognised global priority, clinical definitions derive largely from working-age cohorts. Older adults face high acute severity risk, yet long-term survivorship remains under-characterised. We aimed to characterise and compare clinical PASC phenotypes in older (≥65 years) versus younger (<65 years) adults, distinguishing autonomic, inflammatory and psychosocial manifestations. Method We conducted a retrospective single-centre cohort study of 336 patients attending a dedicated Long COVID clinic at The Beacon Hospital, Ireland
Physical activity is reduced in UK Biobank participants that develop postural hypotension
Introduction Up to 30% of adults over 65 experience postural hypotension (PH) – a significant drop in blood pressure (BP) upon standing. PH is associated with increased risk of falls, frailty, and mortality. Using derived accelerometer data and linked healthcare records, we assessed the relationship between PH and physical activity (PA) in UK Biobank participants. Methods We used UK Biobank derived accelerometery data detailing the average time participants spent sleeping (SlA), sedentary (SeA), doing light activity (LA), or moderate & vigorous activity (MVPA). We ascertained participants with
Systematic review and meta-analysis on the prevalence and determinants of decision regret in older people with chronic diseases
‘Get It On Time’ - Parkinson’s medication QIP
Trends in secondary prevention of hip fracture: National Hip Fracture Database (NHFD) data for England, Wales and Northern Ireland
Trends in secondary prevention of hip fracture: National Hip Fracture Database (NHFD) data for England, Wales and Northern Ireland Antony Johansen, Will Eardley and Liz Fagan Introduction Patients with a hip fracture are at ‘imminent risk’ of further fragility fractures. In 2021 the NHFD introduced a new ‘key performance indicator’ (KPI7: the proportion of people known to be on bone protection 120-days after hip fracture) specifically to address this. In 2023 the ‘Call to Action’ paper published in Age and Ageing challenged clinicians to respond by giving a first dose of intravenous
Management of patients who have “Eating and Drinking with Acknowledged Risk” decision made during hospital stay - QI
Introduction: Eating and Drinking with Acknowledged Risks is an individualised clinical decision balancing risks (may refer to aspiration, malnutrition, dehydration and choking) and benefits (quality of life, pleasure of eating). It may be applied in patients who have irreversible swallowing difficulty, with swallow reflex present where alternative means of providing nutrition are not appropriate. Method: Previous work completed in 2023 looked at cohort of patients where “Eating and Drinking with acknowledged risk” decision was made on Ageing and Complex Medicine ward over 12month period (n=22
Reducing the environmental impact of medications in frail patients on Ageing and Complex Medicine ward at WWL
Introduction: NHS England has set out an ambitious target of delivering the world’s first net zero health service and responding to climate change, improving health now and for future generations. Medicines account for around 25% of emissions from the NHS, from inhalers. anaesthetic and medical gases (5%) and emissions that are embedded in the supply chain of pharmaceuticals (20%). Reducing waste and ensuring appropriate polypharmacy are cornerstones of the NHS strategy to address this, as summarised in the Overprescribing Report. Method: The 3 aims of the project were: Improve deprescribing
Managing Risk Factors in Patients with Mixed and Vascular Dementia
Introduction: Vascular dementia is the second most common subtype of dementia, yet perhaps the most preventable as the underlying pathology is cerebrovascular damage. Therefore, managing vascular risk factors is vital to reduce disease progression. The aim of this study was to assess the management of various risk factors contributing to vascular and mixed dementia patients of the Cardiff and Vale memory clinic. Methods: A retrospective cross-sectional study was conducted, collecting data from 100 patients diagnosed with mixed or vascular dementia between 2022-2024 using WCP and PARIS. Factors
The Geriatric Rehabilitation And Care Enhancement Pilot (GRACE)
Introduction The GRACE initiative was a pilot designed to enhance inpatient experience of older adults. Proportionate moving and handling techniques were introduced as well as increasing the number of therapy staff on a ward reducing reliance on multiple staff for routine ward care. We aimed to improve patients’ functional independence and prevent deconditioning. Methods A ward of 26 patients was chosen with a control comparison and nursing staff were upskilled in proportionate manual handling. For 4 weeks, therapy staffing was increased from 2 therapists to 4 and patients given additional
Modelling the resource implications of starting IV Zoledronate after a femoral fracture.
Introduction In 2023 the ‘Call to action’ paper recommended giving a first dose of intravenous zoledronate (IV Zol) during hip fracture patients' inpatient stay. However the HORIZON study demonstrated the benefit of annual infusions. To help plan service provision we set out to define the constraints on patients reattending for repeated outpatient IV Zol. Method We reviewed local National Hip Fracture Database (NHFD) data for all patients presenting with a femur fracture in 2024. At 120-days a follow-up questionnaire is sent to all patients and we used this to identify those most physically
Hospital At Home self-referral pathway: admission avoidance for older adults
Introduction Hospital At Home (HaH) provides hospital-level care for acute medical issues that would traditionally require admission to an acute hospital bed. HaH with Comprehensive Geriatric Assessment has shown similar outcomes for older people living at home compared to those admitted to an acute hospital (Shepperd et al, 2021). Referral to an alternative from hospital can be slow and tortuous. To reduce this delay and chance of hospital admission, a pilot scheme of patient self-referral into HaH was launched in May 2024 and evaluated. Method Anonymised patient data was retrospectively
CENTRING PERSONAL IDENTITY IN GERIATRIC CARE: IMPLEMENTING THE “ABOUT ME” FORM TO SUPPORT OLDER ADULTS LIVING WITH DEMENTIA
Using Universal Design for Learning (UDL) as a framework to understand Medical Students’ needs and preferences for teaching in Geriatric Medicine
Background: Universal Design for Learning (UDL) is an educational framework promoting multiple means of engagement, representation, and expression to align with diverse learning needs. We applied UDL principles to evaluate teaching methods within the Geriatric Medicine placement at Cardiff University’s School of Medicine, aiming to identify student preferences, explore factors influencing engagement, and inform development of a more inclusive teaching portfolio. Methods: Fourth-year medical students on their Geriatric Medicine placement completed a structured survey about teaching modalities