Abstract
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 University NHS Foundation Trust uses EPIC electronic patient records”. The team aimed to use EPIC to identify eligible patients and record outcomes.
Method: In 2024 the MRI began work with NHS Elect on a Quality Improvement Project aiming to improve reach of the service to improve outcomes. A report was created through EPIC which identified patients eligible for CGA. Using this report the team could identify the demand for the service. Outcomes such as delirium assessment and length of stay (LOS) were also measured.
Results: Data suggests an average of 30 patients aged 65+ are admitted weekly to MVC. Previously, 60% of these patients had a CGA. Data from the EPIC report enabled identification of the resources necessary to reach all eligible patients. A 6-week “Test of Change” was implemented with daily Geriatrician input leading MDT board rounds. As part of the test of change, educational sessions were provided to the nursing staff and medical team. Following the test of change, 100% of eligible patients had a CGA, closed LOS reduced by 6 days on average and delirium assessment compliance reached 100%.
Conclusion: Utilising EPIC, the team have identified the resources necessary to provide CGA for all older people living with frailty in MVC. Providing CGA has improved patient outcomes including delirium assessment and LOS.