Research Abstract: Advanced Trainee - Poster Presentation Only Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Streamlining community dwelling very elderly patients presenting to hospital to receive specialised geriatric care might reduce inpatient length of stay – glimpse from preliminary data (#192)

Imran Dr Riaz 1 , Kevin Dr Ong 2 , Bhaskar Prof Mandal 1 , Janet Dr O’Brien 1
  1. Fiona Stanley Fremantle Hospital Group, Murdoch, WA, Australia
  2. Armadale Hospital, Armadale, WA, Australia

Introduction

The first-of-its-kind Virtual Emergency Medicine (VEM) service in Australia operates from the Fiona Stanley Hospital (FSH) command centre. VEM was designed to reduce patient wait times and improve ambulance and emergency department flow, through the use of video call technology to communicate with paramedics in the back of an ambulance prior to hospital arrival. Acute geriatric patients are referred from VEM to the Rapid Assessment and Treatment Unit (RATU) at Fremantle Hospital, a specialised centre for aged care.

 

Method

Retrospective study of 24 randomly selected direct admissions to RATU via VEM.

 

Results

This sample comprised of 17 female and 7 male patients. Their average age was 84.4 (8.3) years, male 84.0 (6.8) years and female 84.5 (9.1) years. 21 were living at home and 3 were from a nursing home (NH). 13 patients were receiving formal and/or informal supports. Five and 3 patients had level-4 home care packages and domestic services respectively.

Predominant presenting issues were cognition (9 patients), continence (1 patient), or mobility (3 patients) related. 11 patients presented with other issues.

Their average length of inpatient stay (LOS) was 7.5 (6.6) days.

15 were discharged back home (or to their own NH), 6 were discharged to an aged care facility, and 1 was transferred to FSH.

 

Conclusions

  1. Our preliminary data shows that patients presenting to RATU via VEM were predominantly in the mid-old to old-old age range, and were generally still living at home (87.5%).
  2. There appears to be a significant reduction in the LOS compared to traditional service pathways.
  3. The majority were discharged back home (or to their NH; 15/22).
  4. Slightly over half of the presenting issues (13/24) were predominantly geriatric giants.
  5. Further data collection to compare RATU service outcomes to traditional service pathways will clarify the strengths of this unit.