The Frailty Intervention Team (FIT) at Princess Royal Hospital is celebrating one year of enhancing the care of hundreds of older patients attending A&E through quick interventions. These have led to reduced admissions, shorter stays, and improved patient outcomes.
FIT is a new clinical service providing a holistic assessment and intervention to patients over 65 attending A&E with frailty related problems, such as falls, reduced mobility and delirium.
The service is provided by Dr Gen Beckett alongside Specialist Nurse, Amelia Jordan and Specialist Physiotherapist, Sarah Lambert.
Dr Gen Beckett, Consultant Geriatrician said: “We are immensely proud of what we have been able to achieve in just one year. Our aim is for patients to get better as quickly as possible. The service delivers comprehensive assessments within hours, which means patients can get home as soon as possible which evidence shows leads to improved outcomes for patients.”
This multi-disciplinary trio aim to assess patients early in their admission to A&E and make suitable medical interventions, which vary from medication reviews and falls assessments to making referrals to other specialities and community services.
Since the service was introduced, the team has increased the number of outpatient Rapid Access Clinic for Older People (RACOP) appointments, by ensuring the clinic follow up with patients at short notice who have been able to go home after attending A&E.
Working closely with the community physiotherapy team, allows the trio to arrange urgent home visit appointments more efficiently, so patients that the FIT team have supported can be seen quicker by the service.
Amelia Jordan, Specialist Nurse said: “The feedback from our patients has been overwhelmingly positive. We can devote extra time to vulnerable patients to get to the root cause of their problems. They also have the security of knowing that we can see them again quickly in the RACOP clinic if they continue to have concerns or experience problems.”
Developing this pathway for older patients experiencing frailty has ensured they are better managed as they enter A&E. This allows them to have the best possible care within hours of their arrival.
The team are now in the pilot stage of developing an inpatient liaison service to provide specialist frailty advice to inpatients in hospital.
Sarah Lambert, Specialist Physiotherapist explains: “The inpatient service offers an extensive geriatric assessment to patients admitted to wards in cases where they would not routinely see a geriatrician or member of the frailty team. It has been successful in providing an extra layer of advice regarding the management of frail older patients who have been admitted to a speciality ward, other than care of the elderly, such as surgery. As the service develops, we hope to be able to expand the number of patients we can see each day.”
Similar improvements to the care of older patients with frailty problems are also being made at Royal Sussex County Hospital, with the recent introduction of the Frailty Same Day Emergency Care (FSDEC). This service takes referrals directly from GPs and connects these patients with clinical nurse specialists and geriatricians, preventing patients from attending A&E.