Mrs Melinda Williamson1, A/Prof Kristie Harper1,2, Doctor Sarah Bernard1,2, Prof Courtenay Harris1
1Curtin University, Bentley, Australia, 2Sir Charles Gairdner Hospital, Nedlands, Australia
Biography:
Melinda Williamson is an ED occupational therapist with over 15 years’ experience, across Australia and UK. She is current a PhD candidate investigating the health and system outcome of an early allied health frailty service for older adults attending the ED.
Melinda has a passion for acute care of older adults attending the ED. Her research and publications have focused on the care of older adults in the ED, exploring falls guideline adherence, frailty identification and patient activation. Melinda worked with NHS England & NHS Improvement to create online frailty education programs for health and social care staff and caregivers.
Abstract:
Background:
Older adults make up 23% of Emergency Department (ED) presentations, with 40% experiencing frailty. Frailty care is often overlooked due to overcrowding and patient flow issues. International guidelines recommend ED provide 70 hours a week of frailty services, including allied health, with frailty identified at triage and a comprehensive geriatric assessment (CGA) commenced within one hour of presentation. However, research on allied health frailty care in the ED is limited. A recent audit found referrals to allied health occurred 278 minutes from triage, with an additional 77 minute wait for assessment.
Aim:
To implement and evaluate an early allied health service, defined as within one hour of presentation, determining the efficiency and quality of frailty care provided to older adults in the ED.
Method:
A before and after study where patients ≥65 years presenting to a tertiary ED receive either standard care or early allied health frailty service. This early intervention service will identify frailty and delirium risk earlier, provide tailored older adult care to support ED care, aims to reduce adverse events, support patient flow, and provide post discharge support.
Outcomes:
The primary outcome is ED LOS, with the secondary outcomes including ED disposition, wait times, allied health and geriatric team referrals, frailty interventions and healthcare usage and representations within six months. Recruitment of 240 participants will be completed by May 2025 with findings available for conference presentation. This project introduces an innovative ED frailty service, leveraging allied health skills to improve patient flow and optimise frailty care.