Building a Better Health Service

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Frail Intervention Therapy

Frail Intervention Therapy (FIT) Team, Beaumont Hospital

The Frail Intervention Team (FIT) set out to develop a whole system pathway for frail older people to ensure they are managed assertively and their length of stay (LOS) is kept to a minimum.

How it works

Emergency Department overcrowding is associated with increased mortality, increased length of stay (LOS) and patient harm.

The Frail Intervention Team introduced an organisational quality improvement approach to ensure the care delivered is safe, effective, patient centered, timely, efficient and equitable.

Priorities identified were to:

  • Develop an assessment service at the ‘front door’ to enable a multidisciplinary team (MDT) consensus to ensure best possible care for the patient with admission avoidance where possible
  • Create a frail elderly ward in order to implement the frail elderly pathway and support safe early discharge where possible. Ensure ethos of daily decision making, communication and planning for discharge from admission. Prevent deconditioning by promoting independence and activity
  • Expand the existing Day Hospital service as the navigational hub for integrated services to facilitate both admission avoidance and early supported discharge
  • Liaise with community services to support integration and rehabilitation. Coordinate required services across both domains with intention to maintain the older person at home where possible

The team

Development of integrated services for frail older people between primary and secondary care services was possible only through a partnership approach between Beaumont Hospital and CHO9. A project Steering Group and supporting Implementation Team were established in 2016, facilitating a joint approach to service redesign. A number of MDT work streams were formed to shape the service. There is now the use of the frailty trigger across the team, ensuring a common language and ethos.

Impact of this project

This project has reduced the requirement for additional acute care beds, rehab beds and nursing home beds by promoting a home first ethos has saved significant money.

The ultimate success of this project is that the patient gets to reduce their length of stay and go home.

There has been a 28.5% increase in the volume of discharges by Day 10 of admission. 95% of patients are discharged in 49 days in 2017 compared with 65 days in 2015 and bed utilisation has reduced by 13% despite an 11% increase in admissions as our local population gets older.

Feedback from the patients has been overwhelmingly positive:

“Normally, when you leave hospital they forget about you but this service has been brilliant. You've given me my mother back.” (Patient’s daughter)

"This is the best help we've had leaving the hospital. you've given him a huge boost to his confidence“ (Patient’s wife)