Improving planned care for the frail in Morriston Hospital

Background

We have a growing ageing population, coupled with increasing numbers of patients awaiting operations for longer periods of time.  Older and frailer patients are more complex and are associated with longer lengths of stay and worst outcomes postoperatively, making the ability to process the ever growing waiting list more difficult.

Aim

We know that early intervention by geriatricians improves outcomes, with reduced post-operative complications and improved patients outcomes, and with improved utilization of services.  However we do not know who will benefit.

Method

Using PDSA methodology we firstly want to contact everyone on a waiting list to work out who we feel would benefit from a geriatrician led review.  We then intend to review all those patients identified in person, and then assess the benefit conferred to these patients.  We then hope to run validated tools that can identify frail patients to see if any can accurately identify those patients who may benefit from our input, and should be seen in a clinic.  We want to re-run the process to improve the process.

We are also going to seek all the patients involved feedback and run workshops with patients from the project to improve patient experience.

Expected Benefits:

• Improved patient outcomes postoperatively.
• Improved ability to process waiting list.
• Improved patient experience.
• Improved utilization of correct services earlier.