TY - JOUR
T1 - Embedding comprehensive geriatric assessment in the emergency assessment unit
T2 - The impact of the COPE zone
AU - Taylor, Joanne
AU - Gaillemin, Oliver S.
AU - Pearl, Amy J.
AU - Murphy, S.
AU - Fox, Jennifer
PY - 2016/2
Y1 - 2016/2
N2 - We introduced a geographically embedded frailty unit, the comprehensive older person’s evaluation ‘COPE’ zone within our emergency assessment unit (EAU). We collated data for all medical patients over 75 years admitted non-electively for one month before and after this service change. Significantly more patients were seen by a geriatrician on the EAU earlier in their admission in 2014 (33.4 vs 19.3%, p<0.001; 11 vs 20 h, p<0.001). More patients had documented comprehensive geriatric assessment and discussion in a geriatrician multidisciplinary team meeting (relative risk (RR) 3.3, 95% confidence interval (CI) 2.35–4.73, p<0.001; RR 3.6, 95% CI 2.26–5.57, p<0.001, respectively). More patients with markers of frailty were discharged directly from EAU (42.2 vs 29.0%, p = 0.006) without increasing readmissions. Mean length of stay was reduced (9.5 vs 6.8 days, p = 0.02). The introduction of the COPE zone has improved service delivery at the point of access for older people admitted to hospital.
AB - We introduced a geographically embedded frailty unit, the comprehensive older person’s evaluation ‘COPE’ zone within our emergency assessment unit (EAU). We collated data for all medical patients over 75 years admitted non-electively for one month before and after this service change. Significantly more patients were seen by a geriatrician on the EAU earlier in their admission in 2014 (33.4 vs 19.3%, p<0.001; 11 vs 20 h, p<0.001). More patients had documented comprehensive geriatric assessment and discussion in a geriatrician multidisciplinary team meeting (relative risk (RR) 3.3, 95% confidence interval (CI) 2.35–4.73, p<0.001; RR 3.6, 95% CI 2.26–5.57, p<0.001, respectively). More patients with markers of frailty were discharged directly from EAU (42.2 vs 29.0%, p = 0.006) without increasing readmissions. Mean length of stay was reduced (9.5 vs 6.8 days, p = 0.02). The introduction of the COPE zone has improved service delivery at the point of access for older people admitted to hospital.
KW - frailty unit
KW - older people
KW - acute medicine
KW - comprehensive geriatric assessment
KW - readmissions
UR - http://www.scopus.com/inward/record.url?eid=2-s2.0-84957112288&partnerID=MN8TOARS
U2 - 10.7861/clinmedicine.16-1-19
DO - 10.7861/clinmedicine.16-1-19
M3 - Article
SN - 1470-2118
VL - 16
SP - 19
EP - 24
JO - Clinical Medicine, Journal of the Royal College of Physicians of London
JF - Clinical Medicine, Journal of the Royal College of Physicians of London
IS - 1
ER -