Posters

Introduction Delirium is common in older inpatients and associated with cognitive decline, underlying dementia, and mortality. NICE recommends that current or resolved delirium diagnoses are communicated to general practitioners (GPs) upon discharge. A 2021–22 quality improvement project at Lister Hospital improved the delirium assessments consistently to over 95% across the Trust. However, this study found that only 25% of delirium cases were documented in discharge letters. This gap poses significant risks to patient safety, as unresolved delirium may be overlooked, and underlying dementia

Introduction: Inappropriate polypharmacy is the use of medications with no evidence-based indication, unmet treatment goals, high risk of adverse drug reactions, or when the patient is unwilling / unable to take treatment as intended. This is particularly concerning in geriatric care, due to increased risk of hospital admissions, adverse drug reactions and significant healthcare costs. To address these risks, clinicians should conduct patient-focused medication reviews. This project aimed to assess and improve polypharmacy reviews at Royal Albert Edward Infirmary (RAEI), with a focus on

Introduction Dementia is an increasing global health problem. Picture description tasks are a useful tool to assess semantic-based language deficits, which can occur during later stages of dementia. There is a paucity of research regarding culturally appropriate picture description tasks within sub-Saharan Africa. Aim Develop a culturally adapted picture description task and scoring method and evaluate its feasibility as a cognitive measure in two rural communities in the Hai district of Kilimanjaro, Tanzania. Methods An adaptation of a widely used picture description task was developed using

Introduction Multiple long-term health conditions and multimorbidity (MLTC-M) disproportionally impact older people. Literature highlights associations between polypharmacy, mobility issues, and severe mental illness and MLTC-M. Co-existence of polypharmacy, mobility issues, and severe mental illness with MLTC-M may impact on older people’s health outcomes, however the extent to which these have been explored is unclear. Aim This scoping review aimed to describe the evidence regarding interventions and outcomes associated with the intersection of polypharmacy, mobility issues, and severe

Introduction: Manchester Vascular Centre (MVC) is one of the largest Arterial Centres in the UK. It serves approximately 2 million people. Older people who are living with frailty are at increased risk of perioperative complications. Perioperative care for Older People undergoing Surgery (POPS) can reduce incidence of these complications by providing Comprehensive Geriatric Assessments (CGA) (Partridge et al 2017). In Manchester Royal Infirmary, the Older Person Assessment and Liaison (OPAL) team have been providing CGAs for older people living with frailty undergoing surgery. Manchester

Improving the Safety and Continuity of Care for Patients on Apomorphine: A Three-Cycle Quality Improvement Project Cheng Khuang Lim1; Roberta Dewar1; Fern Gibbon2;Carol Miller2 Salford Care Organisation, Northern Care Alliance Background: Delays in the administration of dopamine agonists in patients with Parkinson’s disease can lead to serious patient safety incidents, and transitions of care are a critical period during which medication errors are especially likely to occur. Introduction: Apomorphine is a potent dopamine agonist used as an adjunct therapy in the management of advanced

Introduction In our hospital, 40% of Foundation Year 1 (FY1) doctors reported a lack of confidence in geriatric medicine. To address this gap for new doctors starting in geriatrics, an FY1 Doctors Handbook for Geriatrics was developed. This need was identified during a baseline survey to understand the starting point of the quality improvement work, with the aim of increasing FY1 confidence and preparedness in geriatric medicine. Methods The handbook was created collaboratively with members of the multidisciplinary team (MDT), including outgoing FY1 doctors, registrars, consultants

Introduction Since 2019, ReSPECT forms have been used to document patient wishes and appropriate escalation of treatment in our hospital. This audit examines the quality and completeness of ReSPECT forms in Southmead Hospital across medical and surgical wards, assessing adherence to national guidance as stipulated by the Resuscitation Council UK. The aim is to identify areas for improvement in documentation practices and issues for future QIPs. Methods This was a retrospective audit done for all inpatient wards in Southmead Hospital The acute medical and surgical wards were excluded from the

Background A Quality Improvement Project (QIP) at University Hospitals Dorset involving multiple specialties (Older People's Services, General Surgery, Pain Team, Anaesthetics, Emergency Department, Radiology, Pharmacy) focused on improving care for adult patients with Chest Wall Trauma. Incidence and severity increase significantly with age (recent audits found a 12% mortality), with complications that can be life-threatening. Key to good management are early injury recognition, effective pain control, frailty assessment, and timely escalation planning. Introduction A series of deaths

Background Anticipatory medications (AMs) support symptom management in patients nearing end of life. NICE guidance recommends early, individualised prescribing with shared decision-making. At WUTH, AMs are prescribed via a Cerner PowerPlan. A 2023 quality improvement project (QIP) identified delays in prescribing and inconsistent documentation. Interventions included junior doctor and pharmacist teaching, and feedback to the palliative team. Methods A retrospective review of adult inpatient deaths during October 2024 at Arrowe Park Hospital was undertaken. Exclusions included sudden and

During the period September to December 2024 an individual GPwSI was working across specialist palliative care (0.2WTE) and acute frailty (0.6WTE) concurrently within the same Trust. To allow Specialist Palliative Care consultants to concentrate on ward/inpatient/complex cases, the GPwSI saw a variety of patients where the CNS felt a doctor was needed with unclear or undifferentiated problems. We analysed the case mix and outcomes of 38 cases seen, demonstrating that cross-speciality working has positive outcomes for doctors, patients and services and reduces acute admissions Of the 38 cases

Introduction The 2022 Geriatric Medicine curriculum mandates that trainees demonstrate competence in leadership and management (1). The NHS Long Term Plan and Clinical Leadership Framework emphasise the need to develop clinical leaders capable of driving service improvement across the system (2, 3). However, structured leadership and Quality Improvement (QI) training within higher specialty training remains limited, as demonstrated by recent national evidence (4–5). This one-day teaching programme aimed to provide targeted training aligned with curriculum and NHS priorities. Method A one-day

Introduction Early mobilisation following hip fracture surgery is a key determinant of better health outcomes and reduced mortality. However, high levels of postoperative pain and inconsistent analgesia administration were noted as barriers to mobilisation on our dedicated femoral fracture unit. This quality improvement project aimed to understand pain and analgesia on the unit, and in doing so, target better pain relief to improve outcomes through optimised engagement with therapy. Methods Baseline data were collected on 26 post-operative patients to assess subjective pain scores (or Abbey

Background Falls are a leading cause of morbidity among older people living in care homes. The Action Falls programme includes a multicomponent falls risk assessment checklist and guidance on mitigating actions. It demonstrated a 43% reduction in falls in a clinical trial. Initially developed as a paper-based tool embedded within care plans, Action Falls faced limited adoption when adapted as a standalone digital version. Care homes indicated they could not implement digital checklists that operated outside their electronic care planning systems. Since the COVID-19 pandemic, the Digitising

Introduction Frailty is a strong prognostic predictor. By incorporation routine frailty scoring as part of routine primary care this can help as guide to clinical teams Method In 2021 we recognised that our we needed to improve identification of frailty. We undertook whole team training of nurse, GPs and Health Care Assistants , and incorporated scoring the Rockwood Clinical Scale as a routine part of regular chronic disease reviews and template for those over 80. An alert was added on the clinical system to highlight last Rockwood score or where this remained outstanding. Results In May 2020

Introduction: Falls are a leading cause of morbidity in older adults. NICE guidelines recommend that all older patients admitted with a fall undergo a vision assessment as part of the multifactorial falls risk evaluation. Despite this, compliance in clinical practice is often suboptimal. We undertook a quality improvement (QI) project to assess and improve adherence to this guideline at Wythenshawe Hospital. Method: A retrospective audit of case notes and electronic records was conducted over a 3-month period to evaluate the proportion of patients admitted with falls who had a documented

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

Introduction: Advance care planning is a process that allows individuals to make decisions about their future healthcare, including end-of-life care, by discussing and documenting their preferences, values, and goals with healthcare providers and loved ones. These are especially critical for patients with serious, life-limiting conditions or for frail older adults who may face unexpected health crises. It is a commonly recognised barrier to care planning however that senior doctors often do not have the time to complete it for all patients who require them and that junior doctors lack

Introduction Small, qualitative studies suggest discrepancies between older adults’ measured and self-perceived frailty. Any mismatch will have implications for frailty interventions and advanced care planning. We therefore, aimed to report the relationship between older adults’ self-perceived frailty and the Electronic Frailty Index (eFI), an objective screening tool measure of frailty, in a large, unselected cohort of older people. Method One thousand people aged ≥ 70 years, randomly selected from a single GP practice, were sent a survey, asking them to rate their own frailty using self

Introduction Lack of access to sensory aids like glasses or hearing aids, can lead elderly patients to experience disorientation, difficulties engaging with healthcare professionals, negatively impacting recovery and both patients and their next of kin’s hospital experience. These challenges, combined with a lack of staff awareness of sensory needs of patients on a busy geriatrics ward highlight the need for focused interventions. Methods This quality improvement project utilised the Plan-Do-Study-Act (PDSA) methodology over a 12-week period. Documentation of sensory impairments and aids was