Abstract
Introduction
Ageing & Frailty Standards(1) highlights the importance of identifying frailty at the earliest opportunity. A Community Rehabilitation Service is in prime position to incorporate frailty screening into the electronic healthcare record (EHCR). Clinical Frailty Scale (CFS)(2) is appropriate for this population however was not prompted within the assessment and as a result completion rates were low. The aim was to include the CFS Systematized Nomenclature of Medicines - Clinical Terms (SNOMED-CT) code in the template for all people aged over 65 and monitor completion rates.
Methods
The CFS SNOMED-CT code was incorporated into the EHCR in April 2024. Additionally, training was organised for staff to ensure consistent & standardised recording. The Community Rehabilitation Services work with all adults including those under 65. When CFS scoring was introduced all patients who were assessed by the Community Rehabilitation Service inadvertently could have a CFS score however along with training, the prompt included in the EHCR reminded clinicians to record a CFS only for those over 65.
Results
The data demonstrates a trend of increasing numbers of CFS being recorded on new patients into the service with the monthly average continuing to increase once the prompt was included. There was an anomaly in April 2024 as the wrong SNOMED-CT code was recorded.
Conclusions
The results highlight the value of incorporating prompts and standardised coding of CFS as part of an EHCR. The Community Rehabilitation Services are in a strong position to identify frailty early, record scores and communicate this with other healthcare professionals; adding value for monitoring progression of frailty and effectiveness of rehabilitation in contributing to the reversibility and management of frailty. Furthermore, it highlights the importance of training staff for interrater reliability.
1. Healthcare Improvement Scotland. Ageing and frailty; Standards for the care of older people. [Internet]. 2024. Available from: https://www.healthcareimprovementscotland.scot/publicatoins/ageing-and-frailty-standards
2. Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A. A global clinical measure of fitness and frailty in elderly people. CMAJ.2005;173(5):489-495.