Aims To assess the impact of a statewide improvement collaborative on hospital admission rates and acute inpatient length of stay for older persons.
Methods Thirteen Victorian metropolitan health services participated in an 18-month improvement program combining shared aims, peer learning, iterative testing and expert coaching. Participating services tested and adapted front door frailty models and improvements to inpatient care progression within local contexts for older adults (≥65 years, or ≥50 years -First Nations persons). Statewide administrative datasets capturing >100,000 presentations of older persons were aggregated. Statistical process control methods assessed changes in admission rates and acute inpatient length of stay (LOS), with emergency department (ED) LOS, re-attendance, and re-admission monitored as balancing measures. Qualitative insights from model variation and local testing informed interpretation of quantitative findings.
Results From September 2024 - February 2026, a statistically significant reduction in hospital admission rates for older persons was observed (2.6% absolute, 5% relative improvement-12 months prior). A statistically significant reduction in acute inpatient LOS was also observed (approximately 2,500 fewer admissions and estimated 60,000 bed days saved statewide). No adverse signal was detected in ED LOS, re-attendance, or re-admission rates.
Conclusions A statewide improvement collaborative focused on front door frailty redesign was associated with meaningful and sustained reductions in admissions and acute inpatient LOS for older persons. Through system level implementation and coordination over one model of care, this suggests with implementation at scale and shared data, tailored care and capacity can be achieved rapidly.