Older women’s view on frailty and an Emergency Department evidence-based frailty intervention team (FIT) program: An evaluation using the RE-AIM framework
Kristie Harper1,2,3, Melinda Williamson1, Deborah Edwards1, Jenna Haak1, Annette Barton1, Susan Slatyer4 1Sir Charles Gairdner Hospital, Occupational Therapy, Nedlands, WA, Australia2School of Allied Health, Curtin University, Bentley, WA, Australia3EnAble Institute, Bently, WA, Australia4School of Nursing, Murdoch University, Murdoch, WA, 6150
Abstract
Background: Older women have higher levels of frailty resulting in increased rates of disability and poorer quality of life. Presentation to an Emergency Department (ED) is an opportunity to address frailty and provide tailored interventions to promote function. An ED allied health team integrated frailty assessment and interventions into care through a ‘Frailty Intervention Team’ (FIT) program.
Methods: A prospective study informed by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework to evaluate the FIT program tailored to female older adults discharged from the ED.
Results: Over three-months, 192 older females (>70 years) were identified with mild frailty and discharged directly home. Ninety percent were offered the FIT program with 83.3% accepting all recommended frailty management strategies. A FIT program supported the instigation of a comprehensive geriatric assessment in 65% of patients. Ninety percent of patients were satisfied with the FIT program, however staff and patient barriers to provision of frailty services in the ED were identified.
Discussion: The FIT program was largely adopted by staff and accepted by older female patients with mild frailty in the ED. However, program effectiveness was limited by gaps in communication about frailty in the ED and implementation of frailty management strategies after discharge. These findings can be used to further develop frailty management intervention in the ED for adults with frailty.
Biography
Dr Kristie Harper is an early career researcher and an occupational therapist. Kristie currently works in the Emergency Department (ED) at Sir Charles Gairdner Hospital (SCGH) and holds a conjoint Researcher Coordinator position with Curtin University. She is an active member of the enAble Institute for Health Research. Kristie leads a program research in the hospital setting focused on the acute care of older adults, while building skills and research capacity in clinician researchers. Her current trials have focused on supporting older adults after a fall and exploring the prevalence and outcomes of patients with mild frailty.