Audit Of Clinical Frailty Scale (CFS) Screening In Medical Assessment Unit (MAU) Admitted Patients In A Model-2 Hospital

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Abstract Background This model-2 hospital serves a demographic where 1-in-3 MAU attendees are over 75-year-old. It has been shown that in those where frailty is identified and managed early, outcomes are better. This study audits the newly established frailty screening pathway to capture frailty data on patients from point of admission, commencing January 2024. Methods The Hospital Frailty Committee established a frailty screening pathway for all patients presenting to the MAU. Using the CFS and a bespoke sticker incorporated into the MAU booklets, patients ≥75 years old were routinely screened. In admitted patients, a CFS score of ≥ 6 triggers a referral to the Clinical Nurse Specialist (CNS) of the Older Adult. For discharged patients, a CFS score of ≥ 6 triggers referral to the public health nurse. We compared the completion of the bespoke sticker to number of onward received referrals to the CNS via electronic referral system. We measured i.) proportion of completed bespoke stickers; ii.) quality of sticker completion and iii.) proportion of appropriate triggered referrals (inpatients). Results We identified 34% (n=94) of 247 MAU attendees as meeting the criteria for frailty screening (age≥75) for which the MAU booklet was reviewed manually. A total of 81% (n=77) had a bespoke sticker in their documentation, 71% of which were completed (n=55). Of these 55, 72% (n=40) were admitted with a median CFS of 6 (Average 5.5). Of the 40, 57.5% (n=23) were referred and seen by the CNS, 35% (n=14) were not referred (appropriately), 2.5% (n=1) not referred who should have been and 5% (n=2) were referred but not seen. Conclusion Establishment of this pathway and subsequent audit highlights the high level of frailty in our patient cohort. In addition, 5% of admissions would have benefitted from CNS input, but didn’t get it, highlighting need to further expand and develop service.