99 Pathfinder: a retrospective review of the first sixty patients

Abstract

Abstract Background Pathfinder is designed to safely keep older adults who phone 999 at home by utilising alternative care pathways rather than taking them to a hospital Emergency Department (ED). Pathfinder began as a pilot initiative from a collaboration with Beaumont Hospital and the National Ambulance Service (NAS) in 2018. Due to its success a permanent team was set up in March 2020. The NAS began to roll Pathfinder out nationally and this team went live in the first quarter of 2023. Methods The first 60 patients who were seen by this Pathfinder service were included in a retrospective review. Data was collected using a Microsoft Excel® worksheet. The data recorded included: age, gender, Clinical Frailty Scale (CFS), the presenting complaint and the outcome of the assessment. Results Of the first 60 patients the mean age was 79 years, 48% (n = 29) were male and 52% (n = 31) were female. The median CFS was 6 indicating a moderately frail cohort. A total of 58% (n = 35) of patients remained at home after initial assessment, 74% (n = 26) received follow-up from the Pathfinder team, and 26% (n = 9) were treated and discharged at the scene. A total of 94% (n = 33) remained at home within 24 hours after initial review, and 80% (n = 28) remained at home after 7 days. A remaining 42% (n = 25) of patients were conveyed to ED at initial assessment. Of these patients, 76% (n = 19) were admitted and six patients were discharged home from the ED, of which four (67%) received follow-up from the Pathfinder team. Conclusion This new Pathfinder service to the area provides a safe alternative pathway to older adults who contact emergency services, with 58% of patients remaining at home post Pathfinder intervention. Further research is required to investigate the patient experience of the service.