53 Development of Early Supported Frailty Discharge Team

The aim of the audit is to find out whether Rockall clinical frailty score (CFS) has an effect on hospital admissions, such as length of hospital stay, readmission within 30 days after discharge. By knowing the association, we can provide early supported frailty discharge team’s service to patients with specific frailty scores to reduce 30-day readmission rate.

58 patients from Geriatric wards of Southend Hospital including age, reason of admission, and Proactive Elderly Advanced Care Plan (PEACE) status were collected as a baseline. Admission status, length of hospital stay, readmission and mortality were recollected on a weekly basis in the month of October and November 2019, together with clinical frailty score documented on discharge.

The analysed data was left with 37 patients, after excluding 22 patients whose clinical frailty scores not documented on discharge.

Clinical frailty score was independent of age. 85% of the patients were CFS 6 and above, 15% were CFS 4 and 5.

The mean length of stay was 15 days. The severity of frailty was directly proportionate to the average number of days spent in hospital. Patients with CFS 9 had the highest mean hospital stay of 18 compared to 22 days in the group of CFS 4.

Significant 30-day readmission rate (33%) was seen in patients with clinical frailty score of 5 and 6. Patients with upper extreme end of frailty scores were associated with mortality, 83% in CFS 9. In 5 out of 20 patients with CFS of 7 and above, PEACE was put in place. It might explain the reason why there were relatively lower readmission rates in such groups.

From analysis of our data collection, CFS is a good predictor of duration of hospital stay which is in line with previous studies. Severity of frailty may help indicate the likely risks and frailty-related outcomes and help to plan treatments and interventions which may decrease length of stay. As a part of quality improvement project, we are introducing community early supported discharge team to CFS 5 and above patients.