1989 Improving accuracy of Clinical Frailty Scale (CFS) scoring on geriatric and oncology wards in Hull University Teaching Hospitals

Abstract

Abstract Introduction The Rockwood Clinical Frailty Scale (CFS) is a tool that assesses global frailty, validated for use in people aged over 65. It assesses an individual’s functional status to assign a number from 1 (very fit) to 9 (terminally ill). Hull University Teaching Hospitals has integrated mandatory CFS assessment on admission for inpatients aged over 65. This project aimed to improve the accuracy of CFS scoring in an oncology and a geriatric ward by empowering ward nurses to better recognise frailty. Methods Phase 1. Baseline data was collected from admission CFS scores from inpatients on one geriatrics ward and one oncology ward. We then individually reviewed admission CFS scores for the same patients. We recorded concordance if the same score was assigned. Phase 2. We surveyed nursing teams on both wards, as they assign the initial CFS score during a patient admission. This revealed unanimous recognition of the pivotal role accurate frailty recognition plays in targeting individualised frailty intervention and called for more staff training in frailty/CFS. Following this, we introduced a pictographic version of the Rockwood CFS scale to nursing stations where admission documentation takes place and re-assessed CFS score concordance. Results A substantial improvement in CFS score concordance was demonstrated within the geriatric ward, from 41% at baseline to 56%. However, only minimal change was observed within the oncology ward remaining static at 11.1% from baseline 8.3%. Conclusions We have worked with the two wards to disseminate knowledge and use of the NHS CFS app. Through collaboration with the trust’s frailty leads, the CFS app is now being incorporated into the electronic recording system, encouraging routine use of the app when calculating CFS scores. Once this change is implemented, we will recollect data again.