Frailty Management In The Emergency Department (ED)
At some point in their lifespan, older people who are frail (or at -risk) will attend the Emergency Department (ED). Our research aims to inform the development and implementation of models of care in the ED that will translate to better outcomes for older people admitted to or discharged from our hospitals.
- The utility of frailty and activities of daily living assessments in the management of emergency department patients from nursing homes
Lead Investigators: Professor Renuka Visvanathan, Dr James Smyth, Dr David Yu, Dr Kandiah Umapathysivam, Dr Ivanka Hendrix, Dr Mandy Archibald, Dr Agathe Jadczak, Dr Catalin Tufanaru, A/Prof Olga Theou, Prof Hugh Grantham and A/Prof Glenn Arendts
Transfers of Nursing Home (NH) residents to the Emergency (ED) are frequent, preventable sometimes and associated with demands on resources and costs. The majority of the patients are frail.
Research is therefore occurring on the roles of assessments of frailty and activities of daily living (ADL) at the NH for residents in relation to decision making about transfer to the ED as well as after transfer in relation to decision making on ED management and admission. The assessments include a determination of the severity of the frailty as well as the ability for ADL’s or dependence. Scoping reviews on the assessments’ roles are progressing and showing evidence gaps in the literature on the assessments being done and having a role in the ED in decision making on investigations and treatment.
In a concurrent qualitative project, ED physicians are being interviewed on their perspectives of frailty. Data are being collected and analysed at present. Planning is advancing for a prospective study on NH resident disability and health consequence; it is part of the Frailty In Residential Sector Over Time (FIRST) project. The aim of this study is to investigate the disability trajectory of NH residents at one year and the association between disability levels as assessed by the Katz scale and health outcomes (eg ED transfer) and mortality in NH residents at one, two and three years.
It is hoped that awareness of frailty as well as ADL’s ability will benefit health professionals and NH residents with less transfers and hospital admissions when feasible and ongoing care instead at the NH and reduced costs.
Media Contact: Professor Renuka Visvanathan