Leveraging the Electronic Health Record to Deliver High Fidelity Comprehensive Geriatric Assessment in the Emergency Setting
Introduction Comprehensive Geriatric Assessment (CGA) in the emergency department can reduce length-of-stay and prevent functional decline in older adults. However, CGA is a complex intervention requiring multi-disciplinary input and appropriate resource investment, making it challenging to deliver for ‘front-door’ frailty services. We hypothesised that improved utilisation of existing functionality within the electronic health record (EHR) could enhance delivery of high fidelity CGA in the emergency setting. Methods Quality improvement methodology was employed to evaluate a standardised
Comparing paramedic and geriatrician Clinical Frailty Scale scores: a baseline evaluation to improve frailty pathway allocation
Introduction Accurate prehospital frailty scoring allows direct admission to older persons' assessment units (OPAU), enabling early comprehensive geriatric assessment (CGA) and reducing unnecessary hospital admissions. The Welsh Ambulance Service Trust (WAST) uses the Clinical Frailty Scale (CFS) to guide pathway decisions, and patients scoring ≥5 may be eligible for direct OPAU admission. We compared paramedic CFS scores with those derived from in-hospital CGA, and surveyed paramedics about their training needs. Method We undertook a single-point data collection across OPAU and acute
Inadequate Footwear in Older Medical Inpatients: An Overlooked Target for Falls Prevention and Mobility Promotion
Transforming Weekend Flow: The Impact of a 7-Day Acute Frailty Service on Older Patients
Music based interventions to reduce agitation in nursing home residents diagnosed with dementia- a systematic review
I’m A Medically Fit Patient...Get Me Out Of Here!
Evaluating the Impact of a Pharmacist Independent Prescriber Service to the Older Person’s Acute Medical Unit
Audit to Improve Discharge Summaries as per RCP Checklist
Introduction: A discharge summary is the primary and most important way of communication between primary and secondary care. Patients when discharged should have a good discharge summary as it works as handover between hospital doctors and the community medical services. The Royal College of Physicians (RCP) has a checklist for discharge summaries which shows the amount of information that should be added in the discharge summary. Method: 40 patient Data was collected retrospectively for patients who were discharged from Older Persons Assessment Unit (OPAU)- Morriston Hospital in August 2025
Testing a novel Clinical Assessment Tool to identify Hospital-Acquired Deconditioning
Improving Medical Students' Confidence in Caring for Acutely Unwell and Dying Patients Using Simulation-Based Training
Age as a Poor Proxy for Frailty Complexity: A Comparative Analysis of 2023 and 2025 Frailty Census Data
Introduction Frailty represents a multidimensional vulnerability associated with adverse outcomes in hospital and community settings. Despite this complexity, chronological age is often used as a surrogate marker for frailty severity. This study evaluates whether age reliably reflects frailty complexity by analysing two frailty census datasets collected in 2023 and 2025. Method Two frailty data sets at PPH (June 2023 and December 2025) were examined. Key variables extracted included age and Clinical Frailty Score (CFS). Data were cleaned and converted to numeric formats. Only rows with valid
“How Frail is our Hospital?”: A Comparative Analysis of Frailty Admissions in Prince Philip Hospital June 2023 and December 2025
Introduction Frail older adults account for a substantial proportion of unplanned hospital admissions. This study compares frailty-related admissions to Prince Philip Hospital (PPH) between June 2023 and December 2025 to evaluate changes in patient characteristics, prescribing burden, and admission pathways following standardisation of frailty data capture. Method A retrospective analysis was undertaken using standardised frailty datasets from June 2023 (n=77) and December 2025 (n=113). Variables included age, Clinical Frailty Score (CFS), polypharmacy prevalence, Anticholinergic Cognitive
Improving recognition and management of acute delirium in older adults: A quality improvement project
Comparison of polypharmacy and ACB in a cohort of older adults living with frailty at a DGH in Southwest Wales between 2023-2025
Introduction Polypharmacy is defined as use of 5+ medications. An anticholinergic burden score (ACB) 3+ increases risk of adverse outcomes in frail patients including falls, cognitive decline, and mortality. Optimising older adults’ medication regimen is a critical element of Comprehensive Geriatric Assessment (CGA). Method In December 2025 a frailty census was completed at Prince Philip Hospital (PPH). Criteria for inclusion were age ≥65 years. Data was collected for a range of metrics including Clinical Frailty Scale score (CFS), polypharmacy, anti-cholinergic burden, and whether admitted
Evaluation of a Training Package for Clinical Frailty Scale Scoring in Urgent and Emergency Care.
Closing the Loop After Discharge: An IMT-Led Telephone Results Clinic in Geriatric Medicine
Introduction Investigations requested as an inpatient were not reliably followed up in our hospital. Poor coordination of post-discharge follow-up can lead to delayed results review, threatening patient safety. This uncertainty contributes to increased length of stay, a risk factor for deconditioning and delirium. In older adults, results must be reviewed in the context of a Comprehensive Geriatric Assessment, allowing robust advanced care planning and ensuring onward investigations are tailored to the individual. We implemented a consultant-supervised, Internal Medicine Trainee (IMT)-led
Delirium in Older Adults Admitted With Acute Stroke: Prevalence, Risk Factors, and In-Hospital Outcomes
Introduction Delirium is a common, but frequently under-recognised complication in older adults admitted with acute stroke and is associated with adverse clinical outcomes. Data describing the prevalence, clinical profile, and impact of delirium in older adults with acute stroke in Sri Lanka are limited. Methods This descriptive cross-sectional study included 90 adults aged ≥60 years admitted with acute ischaemic stroke (including transient ischaemic attack) or haemorrhagic stroke to Professorial Medical Unit at Colombo South Teaching Hospital, Sri Lanka. Delirium was assessed using the
Quality Improvement Project: Improving Multidisciplinary Meeting Documentation on Older Person Wards with an EPIC SmartPhrase
Formation of a Frailty Assessment Unit - From Pilot to Reality
Background According to Healthcare Improvement Scotland, all hospitals should have an established frailty assessment area with access to a specialist frailty team within 4 hours of admission (or within 12 hours when out of hours). Timely CGA on admission is linked to improved patient outcomes. Last year at University Hospital Wishaw (UHW), a Rapid Access Frailty team (RAFT) with dedicated frailty beds was introduced over a 10-day period. They found an improvement with length of admission and discharge rates as well as positive feedback from staff. Following this pilot, a new Frailty Assessment
Prediction of thirty day mortality using clinical risk scores in patients over sixty-five receiving systemic anticancer cancer therapy
Introduction: One third of cancers are diagnosed in patients over the age of 65 (1), given we have an ageing population this is going to increase. Tools have been developed to identify older patients at risk of increased morbidity when receiving SACT such as Geriatric 8 (G8) and Cancer and Ageing Research Group chemotherapy toxicity tool (CARG-TT). This project aimed to assess the ability of these and other frailty assessment tools to predict 30 day mortality amongst older oncology patients. Method: Morbidity and Mortality data from a regional oncology department was reviewed to identify