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
The Burden of Behavioural and Psychological Symptoms in Dementia (BPSD) in Post-Diagnostic Memory Services
Introduction: BPSD significantly impact patient wellbeing and caregiver burden [1]. The Cardiff and Vale Memory Service provides integrated assessment, diagnosis and post-diagnostic care to around 5000 community-dwelling people with dementia (PwD) across South Wales. BPSD frequently prompt escalation to the multidisciplinary team (MDT). This project aimed to evaluate the burden of BPSD within the service. Method: Over 5 weeks, surveys were completed for patients discussed at the MDT with BPSD concerns. The survey captured number and type of BPSD features, demographics and routine clinical
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
Antihypertensive Prescribing in Older Adults: Are We Prescribing Correctly?
Introduction Hypertension is highly prevalent among older adults and is a major contributor to cardiovascular morbidity, mortality, and cognitive decline. While the HYVET trial demonstrated benefits of antihypertensive treatment in older populations, the SPRINT trial highlighted increased adverse events with intensive blood pressure control. This highlights the importance of ensuring antihypertensive prescribing in older people is appropriate and evidence-based, particularly in those presenting with falls. Method A retrospective observational review was conducted of 60 adults aged over 75
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
Accuracy of doctors' decision of fast-track discharges: a prospective audit
Introduction: With an ageing population, more people are living with terminal illness, giving opportunities to identify those with predictable shortened life expectancy. The fast-track pathway was developed to speed up funding of care for people expected to die within 12 weeks. Our aim was to investigate the accuracy of doctors’ prediction of death for patients admitted to hospital and referred to the fast-track pathway. Methods: A prospective audit of hospitalised patients who were referred to the fast-track discharge pathway with an expected death within 12 weeks from the date of discharge
CGA: Improving communication at discharge
Introduction: The most recent national frailty benchmarking audit showed that many discharge letters from our Frailty Ward did not document a clinical frailty score (CFS), advanced care planning (ACP) or functional status. This project aimed to improve documentation of the comprehensive geriatric assessment (CGA) for patients seen by the Frailty Intervention Team (FIT) in Craigavon Area Hospital. Methods A baseline audit of 20 discharge letters from the FIT team was performed, assessing whether core aspects of the CGA were documented. Aspects of the CGA included were: CFS, ACP, cognitive
Are Older Adults with Chronic Kidney Disease Receiving the Correct Gabapentinoid Dose Based on Creatinine Clearance?
Introduction: Chronic Kidney Disease (CKD) affects around 10% of the Scottish population and is particularly prevalent among older adults. As renal function declines with age, drug clearance decreases, increasing the risk of systemic toxicity. Gabapentin and pregabalin, commonly used for neuropathic pain in older adults, are renally excreted and can accumulate, leading to sedation, confusion, and falls. Appropriate dose adjustment according to creatinine clearance (CrCl) is therefore essential. Despite national guidance from NICE, BNF, and SIGN, dosing errors in renal impairment remain a