Posters

Introduction Delirium is a common, reversible condition with significant morbidity. Guidelines facilitate diagnosis and management (NICE Delirium Guidelines [CG103]). Previous audits in an acute frailty ward identified areas for improvement in assessment of delirium. In this cycle, a novel admission proforma was implemented to promote adherence to current guidelines. Methods This is a continuation of a previous quality improvement project representing cycles three and four. An admission proforma was co-developed with patients and the multidisciplinary team (MDT), primarily to prompt staff to

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

Title: Unseen Spine: A Case of Infective Discitis masked by diverticulitis in older patient Introduction: Spinal infections include vertebral osteomyelitis, septic discitis, facet joint septic arthritis, and spinal epidural abscesses. The common presentation usually involves back pain, fever, and elevated inflammatory markers, with signs of neurological deficits implying presence of spinal epidural abscess. Spinal infections are infrequent (0.2–3.7 per 100,000 hospital admissions for spondylodiscitis), with relatively higher incidence in elderly patients. Case presentation: We present a case

Title: Unseen Spine: A Case of Infective Discitis masked by diverticulitis in older patient Introduction: Spinal infections include vertebral osteomyelitis, septic discitis, facet joint septic arthritis, and spinal epidural abscesses. The common presentation usually involves back pain, fever, and elevated inflammatory markers, with signs of neurological deficits implying presence of spinal epidural abscess. Spinal infections are infrequent (0.2–3.7 per 100,000 hospital admissions for spondylodiscitis), with relatively higher incidence in older patients. Case presentation: We present a case of

Introduction: Frailty is a clinically recognized condition characterized by increased vulnerability due to age-related decline across various physiological systems, leading to reduced ability to cope with daily and acute stressors . Managing frailty requires a person-centred approach, involving patients, families, and caregivers, and utilizing evidence-based practices such as Comprehensive Geriatric Assessment (CGA), delivered by specialist multidisciplinary (MDT) teams. Research indicates that older individuals receiving CGA are more likely to be alive and living independently at home six

The Frailty Hotline is a follow-up service designed to provide ongoing care and support to patients discharged from the frailty service. Patients who have previously been under the care of the frailty team are given a dedicated phone number that allows them to escalate non-urgent concerns regarding their health. This service ensures that patients continue to receive appropriate care and guidance while remaining in their home environment, reducing the need for unnecessary hospital visits. This quality improvement project sought to evaluate the effectiveness of the Frailty Hotline in reducing

Introduction Frailty is associated with delayed clinical assessment in ED, increased length of stay (LOS) and inpatient mortality. Frail older adults have complex medical and psychosocial problems, difficult to address in ED. In line with the NHS Long Term Plan, our fSDEC pilot aimed: to deliver early comprehensive geriatric assessments (CGA); manage acute presentations to avoid unnecessary admissions; reduce ED waits and reduce the LOS for those admitted. Methods The fSDEC pilot had an ACP, a trainee ACP and two resident doctors (SHO and registrar) with support from a consultant and access to

Implementation of Advanced Clinical Practitioners as part of developing a ‘front door’ frailty service at Weston General Hospital. Weston General Hospital (WGH) site, within University Hospitals Bristol and Weston is developing its front door frailty services with the aim of becoming a centre of excellence for frailty. With up to 55% of admissions resulting in deconditioning (1) and geriatric medicine being the largest specialty in general medicine, there is a clear need for an advanced practitioners. 21.4% of Weston-Super-Mare’s population is aged >65 (2); suboptimal management of this

Introduction There is a drive for same day emergency care (SDEC) assessments of older frail patients attending hospitals. Multiple documents suggest how frailty SDEC services could work. Methods A trial of a mobile frailty SDEC, the Frailty Intervention Team (FIT) took place for 4 weeks in October 2020.. Data were collected manually but most of the presented data was indirect, such as length of stay of all older frail patients, rather than directly related to who FIT had seen. As FIT developed it was clear that data collection required automation. This was achieved through use of specific

Introduction Delirium is a common presentation in frail, older, hospitalized patients (approximately 25% of admissions, with 50%+ on surgical wards), with a high mortality (approximately 22% during the hospital stay) with more associated, avoidable deaths than sepsis. Delirium is underdiagnosed. The National Institute for Health and Care Excellence (NICE) recommend using a validated screening tool on all patients at risk or showing evidence of delirium. “Getting it Right First Time, Geriatric Medicine” recommends all patients aged 75 or more, should be assessed using the 4AT tool (a validated

Introduction “Getting it Right First Time – Geriatric Medicine” recommends the Clinical Frailty Scale (CFS) should be completed in patients aged 75+ on arrival in the Emergency Department (ED). Frailty services should focus on patients with a score of 5 or 6. The CFS has been shown to be easily completed in ED, however completion was variable. Methods A Frailty Intervention Team (FIT) based in ED was developed at the Royal Lancaster Infirmary. Around the same time the CFS was embedded into the trust’s electronic Manchester Triage Tool (MTT-CFS) within the Electronic Patient Record, along with

Introduction: With an aging population, the number of patients living with frailty will rise. Thus, there is a growing recognition by educators that medical students must be adequately prepared to meet the needs of this population group. To achieve this, one Scottish medical school is carrying out curriculum redesign, including exploring how to add frailty to the curriculum. Informing this process, and education on frailty more widely, this research aimed to explore how educators within this Scottish Medical School perceived frailty and determine how teaching on frailty should be approached

Introduction The UK population is ageing quickly, with the number of individuals over 65 rising from 9.2 million to 11 million in the last decade. This increase has led to more comorbidities and complex treatment regimens, often referred to as polypharmacy, which can cause adverse effects, increase admissions, mortality and high healthcare costs. To address these issues, the NHS is adopting a patient-centred approach to optimise medication use and improve outcomes. This includes evaluating patients, setting shared goals, and identifying unnecessary or harmful medications. Data was gathered

Ensuring Consultant Geriatrician reviews for patients on the Older Persons Assessment Unit. Weston General Hospital (WGH) is working towards becoming a centre of excellence for frailty in keeping with its demographic. As part of this, there is a purpose-built Older Persons Assessment Unit (OPAU) compromising of 14 beds and Geriatric Emergency Medicine (GEM) unit compromising of 3 beds. Our OPAU medical team alongside the therapy team strive to ensure that each patient is reviewed by a Consultant Geriatrician during their admission, in addition to the routine medical and therapy teams to ensure

Introduction: Polypharmacy contributes to frailty, financially strains healthcare resources and causes unplanned hospital admissions. We audited how our Frailty Same Day Emergency Care (SDEC) addressed polypharmacy and the yearly financial impact of deprescribing on the NHS. Method: We analysed two months of patients seen and recorded medication changes in Excel. The BNF was used to provide the minimum NHS indicative price for a medication. Cost was calculated based on a year of prescribing for medications started, stopped or altered. For PRN medications, single pack usage was assumed. The

Introduction The development of specialist acute frailty services is well recognised as crucial to meet the needs of our ageing population and is recommended by the NHS England Long Term plan. At the same time, same day emergency care (SDEC) services are rapidly expanding as an alternative to ED However, to date there is a limited evidence base for specialist frailty SDEC units. Methods We ran a 6-week pilot of a 7-day specialist frailty SDEC open from 8am-6pm. The unit was staffed by consultant geriatricians, frailty ACPs, specialist nurses, junior doctors, a therapy team and resident

Introduction: Frailty scoring is important for the identification of frailty. Frailty assessment can aid clinicians in targeting comprehensive geriatric assessment to improve patient experience and outcomes. We explored the feasibility of self-assessment for frailty, comparing patient-reported scores with specialist clinician assessments, evaluating its potential as a tool for improving frailty identification and intervention. Methods: Between August 2024 and January 2025, a modified Rockwood frailty score with eight descriptive categories was issued to patients in the Older Person’s

Introduction: Urgent Community Response (UCR) teams need innovative solutions to deliver timely and effective care to frail older adults. This project explores the combined impact of remote assessment, continuous monitoring, and AI scribes to enhance UCR service delivery, aiming to improve patient care, staff efficiency, and resource utilisation. Methods: This service initiative integrates three key remote technological interventions within a UCR frailty service: Assessment: Digital examination devices (TytoCare) were used by Clinical Support Workers for remote clinician assessment. Data from

Background: Falls in people with dementia often result in physical and psychological impacts, reducing independence and increasing healthcare costs. Falls place a significant economic burden on the healthcare system. Although individuals with dementia face a heightened risk of falling, there is limited evidence supporting effective home-based interventions for this population. Methods: A mixed-methods process evaluation was embedded within a pilot cluster randomised controlled trial, guided by a realist framework. The evaluation was conducted across six UK sites (three intervention, three

Introduction: Urgent Care Response (UCR) provides a rapid assessment, diagnostic and treatment service to prevent hospital admission. Occasionally, patients under the UCR team require acute hospital admission. Patients were experiencing long waits in the Emergency Department (ED), despite being referred directly from the UCR team due to the ED triage system. National Institute for Health and Care Excellence (NICE) recommends ensuring coordinated and patient-centred transfer of care from one healthcare team to another. We created an electronic alert icon to notify UCR referred patients to the