Posters

Introduction In our hospital, 40% of Foundation Year 1 (FY1) doctors reported a lack of confidence in geriatric medicine. To address this gap for new doctors starting in geriatrics, an FY1 Doctors Handbook for Geriatrics was developed. This need was identified during a baseline survey to understand the starting point of the quality improvement work, with the aim of increasing FY1 confidence and preparedness in geriatric medicine. Methods The handbook was created collaboratively with members of the multidisciplinary team (MDT), including outgoing FY1 doctors, registrars, consultants

Introduction Since 2019, ReSPECT forms have been used to document patient wishes and appropriate escalation of treatment in our hospital. This audit examines the quality and completeness of ReSPECT forms in Southmead Hospital across medical and surgical wards, assessing adherence to national guidance as stipulated by the Resuscitation Council UK. The aim is to identify areas for improvement in documentation practices and issues for future QIPs. Methods This was a retrospective audit done for all inpatient wards in Southmead Hospital The acute medical and surgical wards were excluded from the

Background A Quality Improvement Project (QIP) at University Hospitals Dorset involving multiple specialties (Older People's Services, General Surgery, Pain Team, Anaesthetics, Emergency Department, Radiology, Pharmacy) focused on improving care for adult patients with Chest Wall Trauma. Incidence and severity increase significantly with age (recent audits found a 12% mortality), with complications that can be life-threatening. Key to good management are early injury recognition, effective pain control, frailty assessment, and timely escalation planning. Introduction A series of deaths

Background Anticipatory medications (AMs) support symptom management in patients nearing end of life. NICE guidance recommends early, individualised prescribing with shared decision-making. At WUTH, AMs are prescribed via a Cerner PowerPlan. A 2023 quality improvement project (QIP) identified delays in prescribing and inconsistent documentation. Interventions included junior doctor and pharmacist teaching, and feedback to the palliative team. Methods A retrospective review of adult inpatient deaths during October 2024 at Arrowe Park Hospital was undertaken. Exclusions included sudden and

During the period September to December 2024 an individual GPwSI was working across specialist palliative care (0.2WTE) and acute frailty (0.6WTE) concurrently within the same Trust. To allow Specialist Palliative Care consultants to concentrate on ward/inpatient/complex cases, the GPwSI saw a variety of patients where the CNS felt a doctor was needed with unclear or undifferentiated problems. We analysed the case mix and outcomes of 38 cases seen, demonstrating that cross-speciality working has positive outcomes for doctors, patients and services and reduces acute admissions Of the 38 cases

Introduction The 2022 Geriatric Medicine curriculum mandates that trainees demonstrate competence in leadership and management (1). The NHS Long Term Plan and Clinical Leadership Framework emphasise the need to develop clinical leaders capable of driving service improvement across the system (2, 3). However, structured leadership and Quality Improvement (QI) training within higher specialty training remains limited, as demonstrated by recent national evidence (4–5). This one-day teaching programme aimed to provide targeted training aligned with curriculum and NHS priorities. Method A one-day

Introduction Early mobilisation following hip fracture surgery is a key determinant of better health outcomes and reduced mortality. However, high levels of postoperative pain and inconsistent analgesia administration were noted as barriers to mobilisation on our dedicated femoral fracture unit. This quality improvement project aimed to understand pain and analgesia on the unit, and in doing so, target better pain relief to improve outcomes through optimised engagement with therapy. Methods Baseline data were collected on 26 post-operative patients to assess subjective pain scores (or Abbey

Background Falls are a leading cause of morbidity among older people living in care homes. The Action Falls programme includes a multicomponent falls risk assessment checklist and guidance on mitigating actions. It demonstrated a 43% reduction in falls in a clinical trial. Initially developed as a paper-based tool embedded within care plans, Action Falls faced limited adoption when adapted as a standalone digital version. Care homes indicated they could not implement digital checklists that operated outside their electronic care planning systems. Since the COVID-19 pandemic, the Digitising

Introduction Frailty is a strong prognostic predictor. By incorporation routine frailty scoring as part of routine primary care this can help as guide to clinical teams Method In 2021 we recognised that our we needed to improve identification of frailty. We undertook whole team training of nurse, GPs and Health Care Assistants , and incorporated scoring the Rockwood Clinical Scale as a routine part of regular chronic disease reviews and template for those over 80. An alert was added on the clinical system to highlight last Rockwood score or where this remained outstanding. Results In May 2020

Introduction: Falls are a leading cause of morbidity in older adults. NICE guidelines recommend that all older patients admitted with a fall undergo a vision assessment as part of the multifactorial falls risk evaluation. Despite this, compliance in clinical practice is often suboptimal. We undertook a quality improvement (QI) project to assess and improve adherence to this guideline at Wythenshawe Hospital. Method: A retrospective audit of case notes and electronic records was conducted over a 3-month period to evaluate the proportion of patients admitted with falls who had a documented

Introduction The Commissioning for Quality and Innovation (CQUIN) framework sets a 10% minimum and an ideal goal of 30% of acutely presenting patients over the age of 65 to receive frailty assessment scores. Early recognition of frailty helps mitigate risks such as deconditioning. This project aims to assess and improve the adoption of this standard in medical emergency admissions of a Birmingham district general hospital by working with medical admissions teams and frailty services and observing for associated outcome measures. Methodology PDSA methodology was used. Data was retrospectively

Introduction: Advance care planning is a process that allows individuals to make decisions about their future healthcare, including end-of-life care, by discussing and documenting their preferences, values, and goals with healthcare providers and loved ones. These are especially critical for patients with serious, life-limiting conditions or for frail older adults who may face unexpected health crises. It is a commonly recognised barrier to care planning however that senior doctors often do not have the time to complete it for all patients who require them and that junior doctors lack

Introduction Small, qualitative studies suggest discrepancies between older adults’ measured and self-perceived frailty. Any mismatch will have implications for frailty interventions and advanced care planning. We therefore, aimed to report the relationship between older adults’ self-perceived frailty and the Electronic Frailty Index (eFI), an objective screening tool measure of frailty, in a large, unselected cohort of older people. Method One thousand people aged ≥ 70 years, randomly selected from a single GP practice, were sent a survey, asking them to rate their own frailty using self

Introduction Lack of access to sensory aids like glasses or hearing aids, can lead elderly patients to experience disorientation, difficulties engaging with healthcare professionals, negatively impacting recovery and both patients and their next of kin’s hospital experience. These challenges, combined with a lack of staff awareness of sensory needs of patients on a busy geriatrics ward highlight the need for focused interventions. Methods This quality improvement project utilised the Plan-Do-Study-Act (PDSA) methodology over a 12-week period. Documentation of sensory impairments and aids was

Introduction Advanced care planning (ACP) is particularly relevant for those living with frailty, who are at heightened risk of sudden health changes and loss of cognitive ability. The concepts of frailty and ACP are understood differently by older adults and health care professionals (HCPs). This abstract represents the qualitative component of a mixed methods study aiming to evaluate older people’s perspectives of frailty, including how and why they build self-perceptions of frailty, and their perceptions of ACP. Method Ten community dwelling, older adults, (aged seventy years plus)

Introduction Cancer and ageing have a bidirectional relationship: age is the strongest risk factor for cancer, and cancer and treatments can accelerate ageing. Consequently, biological age of patients with cancer is likely to deviate from chronological age. Validated biomarkers of biological age are needed to quantify this and stratify interventions to minimise accelerated ageing. Methods Using the BioAge R Package, PhenoAge was calculated from eight blood test results of patients attending the Geriatric Oncology Liaison Development (GOLD) clinic at Guy’s Hospital between 2022 and 2025

Introduction Elderly inpatients are particularly vulnerable to complications from prolonged antibiotic therapy, such as adverse drug reactions, Clostridium difficile infections, and antimicrobial resistance. On the Care of the Elderly (COTE) wards at Lister Hospital, prolonged antibiotic use beyond guideline recommendations was frequently observed. This quality improvement (QI) project aimed to reduce inappropriate antibiotic durations in patients aged ≥65 using the Plan-Do-Study-Act (PDSA) methodology. Methods: Conducted on Level 9 of Lister Hospital, data were collected from four wards on

Introduction: Polypharmacy—commonly defined as the use of five or more medications—is highly prevalent among older adults and is associated with increased risks of adverse drug events, falls, cognitive impairment, hospital admissions, and reduced quality of life. Inappropriate polypharmacy, where medications provide limited benefit or cause harm, represents a significant patient safety concern. Structured medication reviews (SMRs), supported by validated deprescribing tools such as STOPP/START and Beers Criteria, are essential for identifying and addressing potentially inappropriate

Introduction: Recommendations from the revised European Society of Cardiology (ESC) guidelines (2023) have changed how we manage decompensated heart failure (HF) in acute hospitals. Adherence to ESC guidelines is associated with reduced mortality, readmissions and improved quality of life ( www.escardio.org, 2023). This audit was conducted to compare our practice against the above ESC guidelines. Method: Two PDSA cycles were completed between July 2024 and April 2025 in the Acute Frailty Unit and two Elderly Care wards. Patients presenting with decompensated HF above 65 years were included

Introduction Caring for patients with Parkinson’s disease (PD) approaching end of life (EoL) is challenging. A switch to transdermal rotigotine for dopamine therapy due to loss of an oral route can lead to delirium/agitation and several first-line symptom management medications used at EoL have anti-dopaminergic activity. Aims To analyse and improve prescribing for patients with PD at EoL in an acute hospital setting, focusing on: Dopamine replacement therapy Symptom management Methods Deaths where PD was entered on the medical certificate of cause of death (MCCD) were collated in 3 rounds of