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Physio14: Teamwork can improve older people’s discharge rates, delegates told

11 October 2014 - 9:29am

An interdisciplinary team based at Leicester Royal Infirmary is helping to ensure that frail older people are discharged more quickly and is also cutting re-admission rates.

Dr Simon Conroy

Dr Conroy, presenting with specialist physio Raj Pothini, said that care should be 'coherent, connected and consistent'

That was the message delivered to delegates by geriatrician Simon Conroy and physiotherapist Raj Pothini, a clinical specialist in A&E care.

Dr Conroy stressed that making comprehensive geriatric assessments (CGAs) – which can take minutes, days, weeks or even months to compile, depending on a patient’s condition – were worthwhile because they reduced rates of falls.

Randomised control trials showed CGAs also reduced levels of delirium and institutionalisation, and cut lengths of admissions. Dr Conroy said it was important not to assume that all older people will inevitably be vulnerable. Some people in their 70s and 80s ran marathons and looked after their great grandchildren, he said. But, on the other hand, some people in their 60s could be ‘very disabled, damaged and fragile’.

Video: Dr Simon Conroy highlights the importance of multidisciplinary team working in older people's care

Dr Conroy said that, as a rule of thumb, people aged 85-plus, who lived in a care home or had a cognitive impairment, such as dementia, should be seen as potentially vulnerable if admitted to A&E.

Mr Pothini said that, where necessary, several disciplines were involved in conducting CGAs and that the interdisciplinary team forged links with community services.

By visiting patients at home, hospital-based practitioners could ensure provision was ‘coherent, connected and consistent.’ Staff could also make recommendations about a patient’s need for therapy or social care at home once they had been assessed, he said.

Dr Conroy outlined the creation of an acute frailty unit at Leicester Royal Infirmary, which had 27 beds. This unit admitted patients aged 85-plus who had come into hospital via A&E, and had improved overall discharge rates by up to 10 per cent. Re-admission rates had also fallen steadily, whether over seven-day, 30-day or 90-day periods.

Anna Jones, president of Agile, the CSP professional network for older people, urged members to apply for research grants in 2015.

Four £2,500 awards would be available she said, revealing that not one Agile member had applied when a similar round of grants was announced earlier this year.

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