Factors impacting retention in rehab RCTs with community dwelling older people with frailty: systematic review and meta analysis
The Case for Space: Does a dedicated Frailty Same Day Emergency Care (F-SDEC) unit improve the impact of an acute frailty team?
Background: National and local standards in acute frailty recommend a seven-day service, with front-door assessment and a dedicated frailty area. Many acute frailty teams struggle to maintain a dedicated space as they are vulnerable to becoming inpatient areas when bed pressures increase. The Acute Older Persons Unit (AOPU) at Guys and St Thomas' has faced similar challenges and is based on the Acute Admissions Ward and the Emergency Department. This project assessed whether a dedicated Acute Frailty SDEC (F-SDEC) space increased the number of patients seen and the number of same-day
Intersectional Risks and Adverse Drug Events in Older Adults: A Scoping Review
Introduction Adverse drug events (ADEs) in older adults contribute to preventable harm, hospitalisation, and health inequalities. While age-related physiological changes affecting drug safety are recognised, less attention is given to how sociodemographic and structural factors such as ethnicity and deprivation jointly shape vulnerability to ADEs. This limits the development of equitable medication safety strategies. This review examines how intersectional risks are conceptualised and analysed in ADE research to inform more inclusive approaches to medication safety. Method A scoping review was
Digital CGA: Innovation, Implementation, and Audit-Driven Evaluation
Introduction The Comprehensive Geriatric Assessment (CGA) is the gold standard for managing frailty in older adults, with strong support in the literature. However, gaps remain in the evaluation of electronic CGA's (eCGA's) and standardised implementation. The Frailty Intervention Team at Sandwell and West Birmingham delivers multidisciplinary care via CGA, but prior to intervention, assessments were often incomplete, with baseline compliance at just 23%. This was largely due to the absence of a user-friendly, embedded electronic solution. Method A root cause analysis identified key barriers
Preventing future fractures; Increasing compliance to National Osteoporosis Guidelines in a Surrey General Practice
Building better bones, a quality improvement project to enhance bone health in the older person’s unit
Understanding patient experience on the Older Person's Acute Medical Unit (OPAMU) and the acute frailty pathway at UHW.
Introduction: The older population are more likely to suffer from chronic diseases, requiring more frequent hospital admissions, therefore, in University Hospital of Wales there is a dedicated Older Persons Acute Medical Unit (OPAMU). The OPAMU, opened in 2023, admits frail patients directly from the Emergency (ED) and Acute Medicine (AM) Departments for comprehensive geriatric assessment before discharge or onward hospital stay. Main objective: To understand how our patients felt throughout different steps of their journey to the OPAMU. Secondary objective: To assess how the patient
Improving the Weekend Handover Process on Older Adults Medicine Wards at Leeds Teaching Hospitals
Introduction Clinicians covering six older people’s medicine wards reported feeling burdened by requests for weekend review of patients without clear indications, reducing time for patient care. We aimed to standardise the process to streamline reviews, freeing up clinicians to deliver optimal care. Methods We developed a new electronic weekend handover process using existing capabilities within our electronic patient record. The COM-B behaviour change method was used with a focus group of clinicians including PAs, residents and consultants to identify targets to change behaviour. Fifteen
Satisfaction with Shared Decision Making and Decision Regret in Older Adults Undergoing Elective Colorectal Cancer Surgery
Introduction: Involvement of Geriatricians in peri-operative assessment acknowledges the altered physiology of frail patients and helps to evaluate realistic outcomes as part of patient-centred shared decision making. This is with the aim of addressing modifiable risk factors, preventing complications, preparing for a realistic recovery and ensuring that treatment options are aligned to what is important to the patient. There is data suggesting improved survival following geriatric peri-operative assessment but little analysis from the patient’s perspective; their thoughts about the shared
Setting the Research Agenda for Co-existing Dementia and Hearing Conditions: A James Lind Alliance Priority Setting Partnership
Standing Up to Deconditioning: A Multidisciplinary Approach to Enhancing Patient Mobilization
Improving outcomes in fragility fractures: integrating bone health into the acute medical unit
Implementing Frax based Osteoporosis Risk stratification across Geriatric wards in St Cross Hospital Rugby
Enhancing Delirium Documentation at the Hospital-Community Interface
Introduction Delirium is common in older inpatients and associated with cognitive decline, underlying dementia, and mortality. NICE recommends that current or resolved delirium diagnosis is communicated to general practitioners (GPs) upon discharge. A 2021–22 quality improvement project at Lister Hospital improved the delirium assessments consistently to over 95% across the Trust. However, this study found that only 25% of delirium cases were documented in discharge letters. This gap poses significant risks to patient safety, as unresolved delirium may be overlooked, and underlying dementia
Enhancing Delirium Documentation at the Hospital-Community Interface
Introduction Delirium is common in older inpatients and associated with cognitive decline, underlying dementia, and mortality. NICE recommends that current or resolved delirium diagnoses are communicated to general practitioners (GPs) upon discharge. A 2021–22 quality improvement project at Lister Hospital improved the delirium assessments consistently to over 95% across the Trust. However, this study found that only 25% of delirium cases were documented in discharge letters. This gap poses significant risks to patient safety, as unresolved delirium may be overlooked, and underlying dementia
Improving the appropriateness of polypharmacy reviews during hospital admissions: A three-stage retrospective quality improvement project
Introduction: Inappropriate polypharmacy is the use of medications with no evidence-based indication, unmet treatment goals, high risk of adverse drug reactions, or when the patient is unwilling / unable to take treatment as intended. This is particularly concerning in geriatric care, due to increased risk of hospital admissions, adverse drug reactions and significant healthcare costs. To address these risks, clinicians should conduct patient-focused medication reviews. This project aimed to assess and improve polypharmacy reviews at Royal Albert Edward Infirmary (RAEI), with a focus on
Feasibility of a culturally adapted picture description task as a measure of cognition within the older adult population of Hai
Polypharmacy, Severe Mental Illness And Impaired Mobility In Multiple Long-term Health Conditions: A Scoping Review
Utilising Epic to develop a dashboard to drive improvement in care of the older person undergoing vascular surgery in Manchester
Introduction: Manchester Vascular Centre (MVC) is one of the largest Arterial Centres in the UK. It serves approximately 2 million people. Older people who are living with frailty are at increased risk of perioperative complications. Perioperative care for Older People undergoing Surgery (POPS) can reduce incidence of these complications by providing Comprehensive Geriatric Assessments (CGA) (Partridge et al 2017). In Manchester Royal Infirmary, the Older Person Assessment and Liaison (OPAL) team have been providing CGAs for older people living with frailty undergoing surgery. Manchester