78 Comparing the Management of Frailty between a Rapid Access Frailty Team and General Medical Teams at a Level Three Hospital

Abstract

Abstract Background Frailty represents a particularly high risk group of geriatric patients whom require specialized care. Dedicated multidisciplinary frailty teams led by Geriatricians have been shown to provide better outcomes. The aim of this study was to compare the inpatient interventions and length of stay (LOS) between patients under the care of a dedicated Rapid Access Frailty Team (RAFT) versus general medical teams. Methods Data was collected on a total of 163 patients who were screened as frail positive using a screening tool, over a period of 10 months in 2018. Basic Statistical Analysis was used to analyse data. Results Of the 163 patients, 113 were managed by the RAFT and 50 by a medical team. 61.9% were assessed as frail immediately in the Emergency Department, while the remainder where referred to the RAFT from other medical teams. The main reasons for referral were: cognitive impairment (51.3%), poor mobility and safety awareness (70.8%), polypharmacy (82.3%), poor functioning in ADLs (76.1%) and medical reasons (77.9%). Interventions made by the frailty team included: medication rationalization (82.3%), MDT assessment (91.2%) and discharge planning (87%). 49.5% of patients seen by the RAFT had a MOCA score < 22. Of patients managed by the RAFT 100% received Physiotherapy and 96.5% were seen by Occupational Therapy, while in the medical group this was 50% and 42% respectively. The mean length of stay was 9 days in the RAFT group, and 12.4 days in general medical group. Conclusion Patients managed by the RAFT had an average LOS of 3.4 fewer days. We hypothesize that this is linked to earlier identification by the RAFT, earlier referral and more intensive intervention by allied health services, and specialized Geriatric Medical input. We aim to increase the availability of our frailty service within our hospital to optimize the management of our frail patients.