Frailty Projects

Author: Kerry Burrows, Care Home Pharmacist, Quality Support Fund 2019/20

Author: Sarah Clarke, Kelly Cole, Claire Porter, Beverley Watson and Claire Spice, HEE Wessex funded initiative: Quality Support Fund 2018/19

Summary: Identifying sources of variation in rates of falls with injury in over 65-year olds in Southampton and leading change to improve the quality of the service offer. This included focused quality improvement on the Fracture Liaison Service in Southampton, to reduce the incidence of secondary fractures in older people through improved identification and management of people with osteoporosis.

Author: Susannah Cochrane, Public Health Registrar, Individual QI Fellowship 2018-19

Author: See the Person not the Patient Team, PHT, Team Based QI Fellowship 2017/18

Author: Salisbury OPAL Team, Team Based QI Fellowship 2017/18

Author: Bournemouth OPAL Team, RBCH, Team Based QI Fellowship 2017-18

Summary: The aim of this work was to reduce length of stay for Frail Elderly patients 75 years admitted to Respiratory Wards at Queen Alexandra Hospital.

Author: Eleanor Reid, Wessex Geriatric Medicine Trainee, Individual QI fellowship, 2016-17

Summary: The aim of this improvement project was to reduce the time frail patients stay in hospital by 10%, within a year. Using the model for improvement and a PDSA testing approach, we introduced a frailty pathway, a screening and comprehensive geriatric assessment tool and set up our Integrated Frailty Intervention Team. We were successful in achieving a 21% reduction in the length of stay of patients over 75, following these changes.

Author: Yvonne McWean, Quality Improvement Lead, Chief Nursing Office, HHFT, Individual QI Fellowship, 2016-17

Author: Helen Brewah, Community Matron, Solent NHS Trust, Frailty Fellowship, 2016-17

Author: Liz Smith, Clinical Lead Physiotherapist, RBCH, Frailty Fellowship, 2016-17

Author: Karen West, Physiotherapy Team Lead, Southern Health NHS FT, Frailty Fellowship, 2016-17

Author: Elizabeth Kerridge-Weeks, Strategic Manager – Falls prevention team, Southern Health NHS FT, Frailty Fellowship, 2016-17

Author: Kerry Burrows, Pharmacist, PHT, Frailty Fellowship, 2016-17

Author: James Lee, Elderly Care Nurse Specialist, Salisbury NHS FT, Frailty Fellowship, 2016-17

Summary:  This project looked at enabling systems to ensure that salient information from anticipatory care plans were made accessible to relevant clinicians at key moments in the patient journey. The work undertaken identified improvements that could be made in care plans that were in use across Dorset, in terms of timely accessibility to relevant clinicians. To fully improve these a larger systems/IT approach is needed.

Author: Dr Susannah Jackson, GP, GP QI Fellowship, 2015-17 (undertaken part-time) 

Summary: An initial detailed assessment of the current care for the older patients in colorectal surgery demonstrated that improvements were needed with the multidisciplinary team working, input from Older Persons Medicine specialists and delirium management. We tested interventions to ensure these areas were addressed and that older frail patients medical and social issues were recognised and well managed. Over a 6 month intervention period the project demonstrated a 23% reduction in the length of stay of noon-elective colorectal patients over the age of 70 without significant change in readmissions or mortality.

Author: Dr Edward Hewertson, Wessex Geriatric Medicine Trainee, Individual QI Fellowship, 2015-16

Summary: Improvement of the patient journey at the Royal Bournemouth Hospital, ensuring that our frail patients are seen by the right person at the right time, in the right place for the right length of time. The project commenced on ward 4, a general Geriatrics inpatient ward at the Trust.

Author: Dr Tom Bartlett, Wessex Geriatric Medicine Trainee, Individual QI Fellowship, 2015-16

Summary: This improvement work focused on the implementation of an identification tool for older people with frailty who present to the Emergency Department (ED). A frailty syndrome approach was taken for identification. Prior to the improvement work there had been no routine frailty identification screen. Between June and August 2016 85% of those aged 75 years and older were screened. The purpose of this was to lead to improvements in the management and outcomes for patients with frailty. Subsequent initial comprehensive assessment was achieved by a frailty team in 34% of those who were identified as positive between June and August 2016. The conversion rate for presentation at ED to an admission was reduced following the intervention.

Author: Dr Claire Spice, Consultant Geriatrician, PHT, Individual QI Fellowship, 2015-16

Summary:  The QI fellow was the clinical lead responsible for implementing a new Elderly Care service consisting of Care Navigators and Frailty GPs on behalf of a GP federation in the New Forest. The role encompassed the entire cycle of project development including the advancement of a conceptual idea, to installation of a project management team, to recruitment and subsequent delivery of the service.

Author: Dr Anubhav Dhir, GP, GP QI Fellowship, 2014-15