Selecting best-suited “patient-related outcomes” in older people admitted to an acute geriatric or emergency frailty unit and applying quality improvement research to improve patient care

Abstract

The population is aging worldwide, and hospitals are admitting a higher proportion of acutely unwell older people. Population-specific factors such as multimorbidity and frailty in older people compounded by deficient expertise contribute to longer lengths of stay, higher readmission rates, and increased rates of institutionalization. A wide range of acute geriatric care models are currently providing acute care to frail older people and these have been shown to provide a cost-effective high-quality service. In this review, population-specific factors, service models, and a wide range of patient-related outcomes of “at risk” older people admitted to an acute geriatric care unit are explored. In addition, we also discuss data measurements and a quality improvement methodology to improve the delivery of care based on the patient outcome data. We hope, in addition to ensuring effectiveness and sustainability of our current services, this may also enhance academic research. Regular monitoring and evaluation of patient-related clinical outcomes not only improve the patient care and reduce the caregiver burden but also help in implementing quality initiatives to develop existing services.

Keywords:

• frailty
• clinical outcomes
• acute older people
• data
• quality improvement
• cost effective service

Acknowledgments

The authors are grateful to all members of the Department of Geriatric Medicine, Ysbyty Ystrad Fawr for their continued support for research activities. The authors would especially like to thank Rachel Fletcher, ABCi team, Aneurin Bevan University Health Board and Dr Chris Edwards, Research and Development, Aneurin Bevan University Health Board for their support and guidance. The authors would also like to thank Jane Power for her administrative support. The authors would also like to thank Salma Zabaneh for her contributions. No external funding was applied.

Author contributions

IS wrote the first draft and SA completed a critical revision of the review article. All authors contributed toward data analysis, drafting and revising the paper and agree to be accountable for all aspects of the work.

Disclosure

IS has attended the Research Methodology Course, Wales Deanery and the Introduction to Biostatistics course, Cardiff University. IS has also attended the Measurement Lead course from ABCi team, Aneurin Bevan University Health Board and completed Introduction to Good Clinical Practice eLearning (Secondary Care), National Institute for Health Research. IS has widely published service evaluation research and QI research, therefore learning from the listed courses and research experience has been used to draft this review article. The authors report no other conflicts in this work.