J.LLEGO1, B. ZHU1, E. CHONG1
Tan Tock Seng Hospital1
Emergency Department Interventions for Frailty (EDIFY) program was developed as a front door service and has reduced acute admissions, rehospitalization, ED re-attendance, mortality and can benefit in attenuating frailty progression. We wanted to assess the staff’s perceived knowledge and confidence in managing older persons and to explore their satisfaction with current geriatric expert support.
A survey was conducted among ED staff using a locally-designed questionnaire. Each question is scored on an 8-point Likert scale, it was voluntary and written consent was obtained. Descriptive analysis was performed and we reported categorical variables as percentage and continuous variables as mean and median.
The survey revealed that staff lacked confidence in diagnosing delirium or not familiar with advanced dementia care services (median=3), agreed that restraints used on patients with delirium would protect them (median=4). Some are aware of the role of advanced care planning and felt they had good understanding of frailty (median=5). 62.8% participants agreed that the current geriatric expert support is adequate and 84.6% were satisfied with EDIFY. Majority agreed that the EDIFY program enhanced the provision of holistic care in older persons (40%), improved staff knowledge in geriatric care (21%), and improved right-siting of care (20%).
Majority of staff valued having additional geriatric expert support and highlights the need to improve delirium management and knowledge on advanced dementia care at the ED with an aim to deliver frailty-centric care at the front door. The EDIFY program is noticeably an important piece of the puzzle in realizing a frailty-ready ED.