292 Frailty at the front door team compliance with the 4Ms of the international healthcare improvement age-friendly healthcare system

Abstract

Abstract Background Age-friendly health systems entail assessing the 4Ms (1) what Matters to you (2) Mood and Mental state (3) Medication review and (4) Mobility and functional assessment. This study aimed to measure Frailty at the Front Door team compliance with the 4Ms. Methods An abbreviated ‘4MsComprehensive Geriatric Assessment (CGA) was designed. Members of an interdisciplinary team, including geriatric medicine doctors, physiotherapists, occupational therapists, speech and language therapist and dietitian completed CGAs for older patients. Data from scanned CGAs (compliance rate approximately 30%) between January–December 2022 was entered onto Excel by trained administrators. Compliance with the 4Msassessment was retrospectively assessed. Data was analysed using descriptive statistics. Results 588 CGAs were scanned. 96 excluded due to incomplete data (n = 93), or age under 65 years (n = 3). 493 CGAs included. Mean (SD) age was 83 (7.8) years. Female:Male ratio was 1.4:1. Mean (SD) CFS was 5 (1.2). 83% (n = 412) answered ‘what matters to you’. No answer recorded in 16% (n = 81). Common themes were; home (20%), family/friends/pets (18%), functional independence (7%), health (6%), and miscellaneous (40%). 100% had a 4AT documented, mean (SD) 4AT of 2 (2.9). The presence/absence of dementia was recorded in 73% (n = 364). 80% (n = 395) recorded presence/absence of depression. 11% (n = 57) had current or previous depression. 87% (n = 450) had a medication screen +/− review performed. 27% (n = 126) of presentations were related directly to either medications or falls. 96% (n = 473) had a mobility/functional assessment recorded.. Conclusion There was 83% or greater compliance across all areas of the 4Ms Cognition, mobility and functional status demonstrated the highest compliance rates. Data capture was incomplete due to the inefficiency of scanning CGAs onto a database. Incorporating age-friendly systems into FFD practice is feasible. Future steps will be to accredit the Emergency Department as an age-friendly healthcare system.