AIMS
Hospitalized frail older adults are at increased risk of functional decline, morbidity, mortality, prolonged length of stay, and institutionalization. The Short Stay Unit (SSU) was established to manage patients requiring short-term care (<72 hours) and to avoid acute ward admission. SSU is part of the Emergency Department Interventions for Frailty (EDIFY) programme, a front-door geriatric care model providing early multidisciplinary assessment and intervention in the emergency department (ED).
METHODS
Patients presenting to the ED were screened by the EDIFY Advanced Practice Nurse (APN) and right sited to appropriate care pathways, including discharge home, Hospital @ Home, community hospital, or SSU. Patients admitted to SSU received early comprehensive geriatric assessment by physicians, functional assessment by therapists, and multidisciplinary management aimed at timely discharge and prevention of complications related to prolonged hospitalization.
RESULTS
A total of 161 patients was admitted to the SSU. Sixty-three percent were female, with a mean age of 89 years. Most patients had a Clinical Frailty Scale score of 6. The most common admitting diagnoses were fever secondary to infection (n=44) and falls (n=18). The average length of stay in SSU was 3.9 days. Of these patients, 41.61% were discharged home, 25.46% to Hospital @ Home, and 24.22% to a community hospital.
CONCLUSION
This front door, multidisciplinary EDIFY- SSU model is effective in reducing complications associated with prolonged hospitalization by delivering targeted comprehensive geriatric care, early functional assessment, and timely discharge planning with early patient and family engagement.