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When frail older adults attend the Emergency Department, they present unique challenges to the reviewing clinicians and consequently are frequently admitted. Once admitted, these patients are at increased risk of the negative effects of being in hospital. These include hospital-acquired-deconditioning (wasting of the muscles due to moving about less), delirium (new confusion), falling over and hospital acquired infections. As a result, patients can become more dependent and require a significant increase in the support they require to leave hospital. For some it might mean they need to go to a community hospital bed for rehabilitation or into long term care such as a care home.
To reduce this risk a Frailty Assessment Area (FAA) was opened at Warwick Hospital to offer rapid and personalised comprehensive assessment that avoids unnecessary admission to the hospital.
The service works collaboratively with West Midlands Ambulance Service (WMAS), community services, primary care on a range of projects to ensure older adults have timely access to specialised assessment in the most appropriate location. Since opening, the unit has successfully introduced new pathways and practices to keep frail older adults out of hospital, if hospital isn’t the appropriate place for their needs. This ensures people are cared for in the right place.
Ambulance crews, when attending to a frail older adult, can call a frailty consultant based at Warwick Hospital and discuss the best possible treatment strategy for that person. This means if hospital care is not thought to be needed, our Trust’s Urgent Community Response team will go out into the community and provide assessment and treatment in a patient’s home environment. If hospital care is thought to be required following the call or after assessment in the community, WMAS will bring the patient directly to FAA, bypassing ED. The ethos of this service is to ensure people are cared for in the right place.
Our virtual ward service allows patients to get hospital-level care at home (including care homes) rather than in hospital. Patients using the service will be monitored in their own home for a short period (usually less than 7 days) by our multi-disciplinary team and have access to assessment, investigations and treatments that are usually provided in hospital. This may allow patients to safely avoid going to hospital or to leave hospital sooner while still accessing the health care they need.
The unit is located on Fairfax ward opposite outpatients, on the same corridor as Nicholas ward at Warwick Hospital.
The service can be contacted by calling 01926 495321 ext 4335.
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