Avoiding unnecessary hospitalization of the frail and elderly, by ensuring they follow the correct care pathway, is crucial for patient centred care and appropriate use of NHS resources.
Burton Hospitals NHS Foundation Trust have been working on a redesign of the Frailty Pathway from the Emergency Department to Community.
All patients aged 75 and over acutely admitted to the Emergency Department were assessed in order to determine who would be classified as frail. The patients were assessed with the Edmonton Frailty Score (EFS) in order to stratify them for frailty and address them to the right team for the appropriate level of care.
Patients were stratified accordingly with the score as either not frail, mild/moderate or severe frail. Each group were addressed to a different pathway of care and a patient centred care plan was put in place.
All patient data was processed and analysed using a statistical package for data analysis. Preliminary data showed a reduction in the length of stay time bands of 1hr, and 1-4hrs in the ED Medical assessment unit. However, there was an increase in 13-24hrs bands. This may be due to patients being treated and discharged in ED that would have been admitted for a very short time whilst key decisions were made. The number of patients within the 13-24hr time band was predicted to increase, however the number of readmissions reduced.
Overall, the Trust saw a 5% reduction in admission of frail elderly over 75 years compared with the same period of the previous year.