From Crisis DNACPR to Proactive Planning: Advance Care Planning for Care Home Residents With Frailty
From Crisis DNACPR to Proactive Planning: Advance Care Planning for Care Home Residents With Frailty
Improving the efficiency of board round on an acute medical ward in Cardiff
Background The project was started as board round discussions were regularly taking over one hour, reducing the time available for ward work and causing team dissatisfaction. The team involved included the doctors on the ward, the senior nursing staff and members of the therapy teams. Methods In October 2025, a questionnaire was completed by team members asking how they felt board round could be improved. Improvements were then gradually implemented with verbal feedback throughout. Formal feedback was requested in January 2026, with a further round of interventions and feedback collected again
Lightning Learning: Improving Knowledge of Parkinson's Disease in Nurses and Healthcare Assistants on a Frailty Unit
An analysis of “Advance care planning” and documentation of frailty for discharged patients from an acute geriatric ward
Advance Care Planning in Dialysis Patients: Is resuscitation always appropriate?
Embedding Sarcopenia Screening and Assessment in Routine Geriatric Services at a District General Hospital
Introduction Frailty is increasingly prevalent in ageing populations and contributes to rising age‑related conditions such as sarcopenia, which is linked to falls, functional decline and greater healthcare use. Early identification is recommended in EWGSOP2 (2019); SARC‑F offers simple screening, while handgrip strength (HGS) provides objective assessment but is harder to implement routinely. This observational study examined the feasibility of embedding Guideline‑aligned frailty and sarcopenia assessment across inpatient and outpatient services. Methods In March 2022, 70 older inpatients were
Improving the documentation of the weekly multidisciplinary team (MDT) meeting on a care of the elderly ward
I recognised the need for improvement of the weekly MDT discussions on a care of the elderly ward. These meetings focused on ensuring each patient had a comprehensive geriatric assessment completed, and had input from a medical, nursing, physiotherapist(PT), occupational therapist(OT), social worker(SW) and pharmacist perspective. Measures for this project included ensuring a standardised proforma was used to document the MDT discussions. This included ensuring that staff present was recorded, clinical frailty score(CFS), functional status and escalation status for each patient was documented
Improving Documentation in Neck of Femur Fracture Admissions: A Quality Improvement Project redesigning a clerking proforma
RESPECT? Do we have any for our patients?
Introduction It is recognised that CPR should be based on an individual risk-benefit assessment, taking into account the likelihood of success, potential harms, and the patient’s wishes. RESPECT forms have been created to document personalised recommendations for emergency care based on discussions around a patient’s preferences, values, and wishes regarding future treatment and end-of-life care . This project aimed to assess and improve adherence to guidance from the Resuscitation Council UK regarding DNAR decision-making, patient + NOK discussions and documentation of these decisions with
Improving the Diagnosis and Antimicrobial Management of Suspected Urinary Tract Infection in Older Inpatients
Standardising Multifactorial Falls Assessment in a Consultant-Led Outpatient Falls Clinic: A Closed-Loop Audit
Brainomix – A Help or a Hindrance in our developing Stroke Services in South Wales?
Introduction In 2024 we conducted a service evaluation of our new stroke AI in Wales, Brainomix. We reviewed its sensitivity and specificity at identifying large vessel occlusions (LVO’s) on CT Angiograms (CTA’s) for our stroke patients. The purpose of Brainomix being to assist in rapid detection of LVO’s and support decision making around proceeding to mechanical thrombectomy for appropriate individuals. Multiple studies in recent years have demonstrated improved functional outcomes for patients receiving mechanical thrombectomy. Brainomix was hoped to be pivotal in bringing these
Protecting Registrar Training: A Quality Improvement Initiative to Improve Access to Protected SPA and Specialty Clinics
Introduction Supporting Professional Activity (SPA) time and specialty clinic attendance are essential components of higher specialty training. Despite being allocated within work schedules, protected educational time was frequently interrupted by clinical service demands, limiting curriculum progression and trainee development. We aimed to improve reliable access to protected SPA and specialty clinics for Group 1 specialty registrars through low-cost system interventions. MethodA prospective quality improvement project was undertaken in a district general hospital using two Plan–Do–Study–Act
Evaluating the Safety of Opioid Prescribing in Older Inpatients: A Quality Improvement Project.
Can We Predict Prognosis After Hip Fracture? A Review of GSF Accuracy in Orthogeriatric Patients
Background: The Gold Standards Framework (GSF) is a nationally recognised tool used to identify patients approaching the end-of-life and facilitate advances care planning (ACP). Accurate GSF assignment can improve ACP, support preferred place of care and death, and reduce unnecessary admissions. Mortality following hip fracture is currently 6% within one month and varies from 12.1%-35.8 % globally at one year, making accurate prognostication particularly important in orthogeriatric populations. We therefore evaluated the accuracy of GSF assignment in patients aged over 60 years admitted with
Beyond Frailty: The Prognostic Value of comorbidity in Non-invasive Ventilation Outcomes
Introduction: Several studies explored the role of frailty in predicting outcomes in critically ill patients. Frailty has been identified as an independent risk factor for all cause morbidity poor outcomes, including mortality, longer hospital stays and complications Rockwood et al. (2005). Muscedere et al. (2017) found that frailty is associated with worse outcomes in patients receiving mechanical ventilation, however there is limited focus on NIV. While NIV is widely used for managing acute respiratory failure, its effectiveness across varying levels of frailty and comorbidity remains
Back Pain, Bladder Dysfunction and Lower Limb weakness in Older Adults: Improving Recognition of Cauda Equina Syndrome
Functional Recovery Following Revision Total Hip Arthroplasty in Older Adults: A Retrospective Cohort Study
Evaluating Management of Suspected Transient Ischaemic Attacks (TIA) in the Emergency Department
Introduction Suspected Transient Ischaemic Attack (TIA) is a common and important reason for Emergency Department (ED) presentation in older adults. Local guidance recommends that patients should undergo CT head imaging, be prescribed aspirin and referred to the TIA clinic. However, a suspected TIA can create diagnostic uncertainty, making clinical decision-making challenging. We evaluated adherence to the local referral pathway to guide service improvement opportunities and identify variation in management according to final diagnosis. Method We conducted a retrospective audit of TIA
Parkinson's Pills - Do our patients "Get it on Time"?
Introduction: Medication timing is critical for patients with Parkinson's Disease (PD). The 'Get It on Time" campaign strives to have PD patients receive their medications within 30 minutes of prescribed time. Methods: Using PDSA methodology, a list of current inpatients with PD was populated and their medicines reconciliation (med rec) repeated to check accuracy of admission prescriptions. HEMA records were analysed to ascertain how many doses in the last 3-5 days of admission were given >30 minutes late. We also collected qualitative data from patients via an in-person survey, asking how