Redesigning care for frail older people: The impact of an elderly care pathway on admission avoidance, length of stay and readmission rates

Abstract

Background: Increasing age predisposes elderly persons to long-term medical conditions, frailty, and geriatric syndromes such as pressure ulcers, falls, incontinence, delirium and functional decline. Increased hospital stays also have adverse effects on frail older people. Strategies are needed to ensure that elderly people are seen by the appropriate professionals to reduce adverse effects. This study aimed to assess the impact of an elderly care pathway in an emergency department ('front door') on admission avoidance, length of stay in hospital, and 30day readmission rate. Methods:In this single case study, quantitative data on frail elderly persons aged 75 years and over seen by the Acute Elderly Unit (n = 605; AEU group) were compared with those seen by a general medical team (n = 327; non-AEU group) at Barking Havering and Redbridge University Hospitals NHS Trust, UK, to calculate the average length of hospital stay and readmission rates. Members of the elderly care multidisciplinary team were also interviewed, and data analysed using thematic analysis. Results:Length of stay and admission prevention were higher in the AEU group than the non-AEU group. Conclusions:To facilitate quality care for frail older persons, an elderly care pathway is needed that includes early discharge planning, a person-centred approach, intensive multidisciplinary team involvement and joined-up working.Citation: Nathaniel Z, Amin K (2016). Redesigning care for frail older people: the impact of an elderly care pathway on admission avoidance, length of stay and readmission rates. Healthy Aging Research 5:14.