The frailty unit was set up in the Acute Medical Unit on July 2016.
The aim of the service was to provide early geriatrician input for those older patients who present with an acute medical problem complicating ‘frailty’ and who are likely to only need a short length of stay in hospital. ‘Short stay’ is defined as an admission lasting up to 72 hours. The model would be delivered by two acute geriatricians based on AMU.
The patients will be identified in two ways by those Consultants assigned to this model.
- A daily (Monday to Friday) post take ward round which will see appropriate patients admitted in the previous 24 hours
- Allocations on the Monday morning of patients admitted on Friday and Saturday who fulfil the criteria for the service.
|Patients presenting with a frailty syndrome (falls, delirium, declining functional capacity)||Seriously unwell patients|
|Patients with known frailty (often manifested as a need for social care or residence in sheltered or residential accommodation)||Nursing home residents|
|Patients with known dementia||Patients whose primary diagnosis requires care led by an alternative specialist|
It is expected that the consultant conducting the post take frailty round will make contact with the on call teams and will take direct referrals from the post take list.
- After review by the frailty consultant, patients may be managed in one of four ways:
- Discharge from hospital
- Admission to the short stay frailty service on AMU
- Care remains under the admitting consultant
- Patient identified as needing longer term admission under a geriatrician (in which case they may be moved directly to a downstream bed without the need for a stay on AMU)
- Patients admitted to the short stay beds on AMU will remain under the care of the assessing frailty consultant.
- If it becomes evident that a short stay patient will require a longer stay than originally anticipated, they will be flagged as requiring transfer to a downstream bed at the 11am Board Round. Such patients will remain under the care of the frailty consultant pending their transfer.
- At present it is intended to cohort short stay frailty patients on Ward 2. This may be difficult to achieve however given the current bed situation. It is anticipated that on average approximately 20 to 25 patients will be under the care of the frailty consultants.
- Patients requiring follow up will be seen in the Rapid Access (Ambulatory) service for older people run in the Medical Diagnostic Centre.