73 A pilot of introducing Comprehensive Geriatric Assessment (CGA) in older patients admitted to an acute hospital to prevent acute re-hospitalisation

Abstract

Abstract Background Recurrent hospitalisation is increasingly observed in older adults aged 65 or above and, is associated with increased risk of adverse outcomes including delayed recovery, increased morbidity, and mortality. We introduced Performa-based, Multi-Disciplinary Team (MDT) driven Comprehensive Geriatric Assessment (CGA) as a model of care of older patients admitted to an acute Irish hospital, and to see its impact in preventing acute re-hospitalisation after an acute admission. Methods CGA was performed, on inpatients aged 65 or older, admitted to a designated ward which had multidisciplinary team access, via a designed and prescribed Performa, by Advanced Nurse Practitioner and interventions suggested by it, were offered to those patients. The pilot continued for three months. Patients who underwent CGA, were monitored for re-admission at 3 months from the date of their discharge via hospital patient management system. Data was compiled and studied via Microsoft excel spread sheet. Results 28 patients were admitted to the designated ward who underwent the CGA during the time frame of the pilot. 26 (92.8%) patients did neither present to ED nor were admitted to hospital in the immediate 3 months post discharge from the hospital. CGA resulted in various multidisciplinary interventions/referrals on all patients which were studied as secondary aims. The major interventions were MDT referrals (physiotherapy 100%, occupational therapy 85.7%, Swallow Therapists 46.4% and dietetic referrals 32.1%) and deprescribing (50% of patients). Conclusion The pilot showed reduced acute re-hospitalisation rates in older patients undergoing CGA, and an attempt to adopt CGA as model of care in acute hospitals to prevent acute re-hospitalisation in such patients. In the model, CGA also offered multiple interventions including MDT referrals/interventions and deprescribing. Further powered research replicating similar results, is needed to explore and adopt such CGA based models of care in older inpatients in acute hospitals.