Posters for 2025 Autumn Meeting

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

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

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

Introduction: Dementia and hearing conditions are both major public health concerns. Most people living with dementia also live with hearing conditions (e.g., hearing loss, vestibular disorders, hyperacusis). Furthermore, evidence suggests that hearing loss is a risk factor for the development of dementia. There is a critical need for research to explain the association between dementia and hearing conditions and to optimise assessments and interventions for this co-morbidity. This James Lind Alliance Priority Setting Partnership (JLA PSP) aimed to identify unanswered research questions about

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

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

Introduction Dementia is an increasing global health problem. Picture description tasks are a useful tool to assess semantic-based language deficits, which can occur during later stages of dementia. There is a paucity of research regarding culturally appropriate picture description tasks within sub-Saharan Africa. Aim Develop a culturally adapted picture description task and scoring method and evaluate its feasibility as a cognitive measure in two rural communities in the Hai district of Kilimanjaro, Tanzania. Methods An adaptation of a widely used picture description task was developed using

Introduction Multiple long-term health conditions and multimorbidity (MLTC-M) disproportionally impact older people. Literature highlights associations between polypharmacy, mobility issues, and severe mental illness and MLTC-M. Co-existence of polypharmacy, mobility issues, and severe mental illness with MLTC-M may impact on older people’s health outcomes, however the extent to which these have been explored is unclear. Aim This scoping review aimed to describe the evidence regarding interventions and outcomes associated with the intersection of polypharmacy, mobility issues, and severe

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

Improving the Safety and Continuity of Care for Patients on Apomorphine: A Three-Cycle Quality Improvement Project Cheng Khuang Lim1; Roberta Dewar1; Fern Gibbon2;Carol Miller2 Salford Care Organisation, Northern Care Alliance Background: Delays in the administration of dopamine agonists in patients with Parkinson’s disease can lead to serious patient safety incidents, and transitions of care are a critical period during which medication errors are especially likely to occur. Introduction: Apomorphine is a potent dopamine agonist used as an adjunct therapy in the management of advanced

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 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