Improving bowel motion documentation and constipation care on an Ageing and Complex Medicine (ACM) ward
Alcohol Use and Psychological Distress After Hip Fracture in Older Adults: NHS Quality Improvement Project From Silver Trauma.
X-Rays Without the Emergency Department: A Novel Community Model for Frail Older Adults
Introduction Frail older adults frequently attend the Emergency Department (ED) following falls, where radiography is often the sole reason for conveyance. Patients with a Clinical Frailty Score (CFS) >4 represent a disproportionate burden of ED attendance and hospital admission. Delivering mobile community X-ray with advanced paramedic assessment offers an innovative opportunity to prevent unnecessary ED admissions while supporting care closer to home. Method An innovative service comprising a radiographer and an advanced paramedic practitioner (APP) reviewed 999 calls and attended suitable
Right Care, Right Place: Co-Locating MDTs to Reduce Emergency Conveyance
Introduction: Rising demand on urgent and emergency care services requires integrated models that support rapid multidisciplinary decision-making and reduce avoidable hospital conveyance. A pilot co-location multidisciplinary team (MDT), involving Ambulance, Frailty and Urgent Community Response (UCR) services, was implemented to provide senior clinical oversight and coordinated care planning for older adults living with frailty contacting emergency services. Method: A retrospective review of summary data from all co-located MDT sessions delivered during a seven-day pilot period of four-hour
Frailty SDEC: Unlocking Bed Capacity and Ending Corridor Care
Introduction Frailty Same Day Emergency Care (FSDEC) is an approach designed to provide rapid assessment, diagnosis, and treatment for older adults with frailty without requiring hospital admission. By reducing unnecessary inpatient stays, Frailty SDEC alleviates pressure on acute beds, improves patient flow, and enhances overall system efficiency. We explored the efficacy of this across 3 acute hospitals. Method A retrospective review of FSDEC activity was conducted from June 2024 for 1 year, across three sites in Surrey Heartlands ICS: ASPH, RSCH, and SaSH (which launched its service in
Improving the Assessment and Quality of Referrals for Hyponatraemia in a Geriatric Department: A Quality Improvement Project
A Quality Improvement Project to Design a Patient Resource to Empower People to Age and Live Well after Hospital Attendance.
Introduction: Evidence suggests older patients and their carers who attend urgent care settings are unaware they can self-refer to community and charity services for ongoing support. Aim: To use the domains of the Comprehensive Geriatric Assessment (CGA) to design a holistic patient resource that signposts patients, relatives and carers to different services, thereby enabling them to age well or manage changes in ability. Method: The Quality Improvement Project received Trust governance approval (Ulysses no. 8911). A literature review was undertaken to establish whether there were existing
Improving Patient Safety: Assessment and Rationalisation of Urinary Catheterisation Practices in Hospitalised Adults
Introduction Indwelling urinary catheterisation is common in hospitalised adults but is associated with catheter‑associated urinary tract infection, prolonged hospital stay, deconditioning and discomfort when not optimally indicated or reviewed. A two‑cycle quality improvement project in Morriston Hospital aimed to evaluate and improve the appropriateness, documentation and ongoing review of urinary catheter use to enhance patient safety. Method Two retrospective audit cycles were undertaken on adult inpatients with indwelling urinary catheters, using clinical notes and catheter bundles as
Should the Clinical Frailty Score (CFS) be used to guide decision-making among Intensive Care Unit (ICU) inpatients?
Prevalence of Frailty Among Adult Inpatients at a Teaching Hospital in the Kurdistan Region of Iraq
Increasing number of deaths attributed to frailty of old age over the last 7 years
Introduction In many older adults, frailty is due to underlying co-morbidities rather than just due ageing. Frailty was rarely mentioned in the death certificates until the Royal College of Pathologists revised the causes of death list in 2020 which suggests two terms: Frailty syndrome which should be quantified with comorbidities and Frailty of old age if the deceased was above 80. The aim of this study was to identify the trend in deaths coded as Frailty of old age in England and Wales over the last 7 years. Methods We extracted data from the Office for National Statistics. Since ICD
Systematic review of the effectiveness of social prescribing for older adults living with frailty or multimorbidity
Introduction Social prescribing is a widely implemented tool used to support unmet non-medical needs in the community. This systematic review aimed to summarise the impact of social prescribing on a population of older adults living with frailty and/or multimorbidity. Methods This review was conducted in line with PRISMA guidelines for systematic review. Searches were completed across MEDLINE, EMBASE and PsychInfo. Social prescribing was defined as co-ordinated multi-component individualised community-based referrals via a link worker. Studies of adults age 65+ or predominantly older adults
Deprescribing in Frailty (DiF) project; Phase 1 – Scoping the issue
Introduction Deprescribing in older people living with frailty is an evidence-based, structured, patient-centred process aimed at reducing or stopping medications where potential harms outweigh benefits. Evidence suggests that deprescribing is safe and feasible, reduces number of potentially inappropriate medications (PIMs) in older people, without increasing adverse outcomes and leads to modest clinically meaningful benefits. Identifying PIMs is a critical step in deprescribing and Phase1 of this project aims to proactively identify and understand the size of inappropriate polypharmacy in
Patient Perspectives on Medicines and Their Impact on Frailty and Falls: A Qualitative Study
Introduction Frailty and falls are significant concerns for older adults, leading to reduced independence and increased healthcare needs. Medicines, particularly polypharmacy, can contribute to frailty and falls yet patient awareness of these risks remains unclear. Patient engagement is essential to inform strategies that improve knowledge and reduce the risk of medicines related harm. Methods Participants were identified by the local NHS patient engagement team and invited to participate in focus groups. Semi-structured interview templates were designed by the study team. Sessions were
Evaluation of Computed Tomography Head scan reporting on Brain Frailty Markers in an Acute Medical Cohort
Integrating CGA principles and acute clinical assessment into pharmacist-led care home service: A Feasibility Study
Introduction Falls, hospital admissions, and reduced quality of life (QoL) are common among care home residents with dementia. Polypharmacy increases these risks, particularly in those with frailty. Current models of care often lack structured medication review and pharmacist-led reviews rarely include clinical assessment. We assessed the feasibility of a prescribing pharmacist with advanced clinical skills delivering holistic structured medication review alongside acute clinical care in a care home setting. Methods Single-group before-and-after feasibility study in a Glasgow care home
Does the drive to a net-zero NHS affect General Practice access for our vulnerable patients? A systematised narrative review
Introduction The National Health Service (NHS) aims to achieve net-zero emissions by 2045. Telehealth is a potential low-carbon alternative within general practice which might help to achieve this. Despite environmental benefits, concerns remain regarding the impact on vulnerable groups who may face digital exclusion. This systematised narrative review examines how telehealth, as part of decarbonisation efforts, influences access to general practice among vulnerable populations. Methods A systematic search of Medline, Embase and Scopus was conducted using PRISMA guidelines. Eligibility
Metabolic Bone Treatment Service Overhaul: A Quality Improvement Approach
Introduction The Assessment and Rehabilitation Day Unit (ARDU) at Aintree Hospital is responsible for the safe and timely administration of treatments for osteoporosis. In the last 5 years patient numbers have increased significantly, leading to an overwhelmed service resulting in long overdue waiting lists and a burnt-out team. A Quality Improvement (QI) project was initiated to stabilise the service and reduce the overdue waiting list by 50% by October 2025. Method Using a clinical microsystem approach, the team developed a driver diagram and measurement strategy to identify priority areas