Aysha Thomas
Hywel Dda University Health Board
Aim:
To highlight the benefits of introducing Frailty Support Workers in the acute hospital setting and how their interventions bridge the gaps between different healthcare disciplines and lead to improved outcomes and cost savings.
The role allows for individualised patient care in a busy acute environment and has demonstrated to have a positive impact on patient experience and demonstrated a reduction in length of stay.
Context:
Senior nursing staff and ward clinicians recognised that there were difficulties in maintaining existing good clinical practice for frail elderly patients as well as supporting other interventions (mobilising, rehabilitation and group activities).
The complexity of patient needs in a cohort of dependent patients attributed to an increased workload in relation to fundamental patient care, reducing the amount of time available for staff to focus on all patient’s holistic needs.
It has been recognised that for every day a patient spends in bed it takes a further week to rehabilitate them thus increasing patients length of stay, risk of pressure damage and hospital acquired infections. As a result, the Frailty Support Workers (FSW) role was introduced.
Planning & Development:
The role of the Frailty Support Worker (FSW) is to work in conjunction with other members of the multi disciplinary team in assessing patients for frailty.
Through an assessment based on Comprehensive Geriatric Assessment (CGA) FSW can determine a frail older person’s medical conditions, mental health, functional capacity and social circumstances.
Whilst working closely with patients, their families and carers they aim to establish an individual’s previous functional ability which allows them to identify areas contributing to the patients decline and to bring about improvements and interventions to aid return of independence and their previous level of function.
The FSW role has improved patient outcomes and experience, as well as reducing length of stay.
Through frequent mobilisation and improved nutritional input, patients are able to maintain and improve their previous level of function and independence.
A reduction in hospital length of stay by 1 day for the whole ward was recorded following introduction of the FSW for 24 beds which equated to an annual saving of £198,000.
Following introduction of the milkshake rounds by the FSW the nutritional status of patients evidenced improvement with improved nutritional scores and a mean patient weight gain of 1.5kg, with £18,000 saved through reduction in nutritional supplement prescribing.
During April 2016 – February 2017 a total of 147 patients were identified as being suitable for frailty intervention:
- 112 patients gained weight – 76%
- 118 patients Nutritional Screening Score improved or maintained – 80%
- 146 patients frailty scores improved or maintained – 99%
Fit with Prudent Healthcare:
By working in conjunction with other members of the multidisciplinary team and by adopting a prudent view and frailty model that best suits the health needs of a significant frail older population will aid in preventing, preserving and supporting their wellbeing in order to maximise a more positive outcome for those individuals.
