Identification and response to clinical frailty score in the emergency department in a busy district general hospital
Chatterjee, Soumyajit Gupta, Sahil Thin, Kyaing Yi Mon Gundale, Kedar
Chatterjee, Soumyajit
Gupta, Sahil
Thin, Kyaing Yi Mon
Gundale, Kedar
Date
2024-12-01
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Abstract
Introduction: Over 20% of our emergency department (ED) patients are elderly and frail. NHS England now recommends documenting a Clinical Frailty Score (CFS) within 30 min for all patients aged[65 presenting to acute care. Our project aimed to ensure that 30% of patients aged[65 attending A&E or same-day emergency care (SDEC) receive a clinical frailty assessment and appropriate followup by 31/03/24.
Method(s): We collected baseline data on patients aged[65 presenting to our ED from 01/04/23-30/09/2023 (n = 220). Patients were randomly selected by Business Intelligence. We extracted data on CFS documentation and follow-up by either a targeted geriatric assessment and/or Acute Frailty Service (AFS) for those with CFS[6 from our Electronic Patient Records (EPR). Quarterly reaudits (n = 220) followed three interventions:(1) communication and teaching sessions with ED staff in Q3, (2) an acronym expansion campaign, and (3) posters for quick recall in ED in Q4.
Result(s): At Baseline, 15% had CFS recorded, but none went on to have a targeted geriatric assessment/AFS referral. After the first intervention, compliance improved to 27%, with 62.5% of those with CFS[6 receiving appropriate follow-up. The second and third interventions maintained the 27% compliance, with 100% having a CFS[6 completing a targeted geriatric assessment and 64% referred to AFS.
Conclusion(s): Our audit revealed a significant gap in CFS documentation and follow-up referrals. The three interventions significantly improved compliance, but results remain below the nationwide care quality initiative target, indicating the need for more consistent CFS documentation and sustainable follow-up processes.
Citation
Chatterjee S., Gupta S., Thin K.Y.M. & Gundale K. (2024). Identification and response to clinical frailty score in the emergency department in a busy district general hospital. European Geriatric Medicine, 15(1 Supplement), S241. https://doi.org/10.1007/s41999-024-01090-y