Older People in Acute Care improvement programme
With the number of older people increasing in our population,
the need to ensure that they receive appropriate care in our
healthcare system also increases.Our ‘Improving Care for Older
People in Acute Care’ workstream is a two-year programme to improve
the care for older people in acute care. This work complements the
scrutiny programme currently taking
place to identify strengths and areas for improvements across
hospitals in NHS Scotland.
Background to our work
This workstream focuses on 2 key areas:
- care co-ordination – focused on identification and immediate
management of frailty
- cognitive Impairment – focused on identification and immediate
management of delirium.
Here’s more information on these key areas:
Frailty and Delirium
By identifying frail patients on admission to acute care, our
aim is that those patients receive timely comprehensive geriatric
assessment and input from a specialist team on the day of
admission. Our programme focuses on this because evidence shows
that appropriate and timely screening:
- assessment reduces length of stay in hospital,
- improves patient experience.
Older people and people with dementia, severe illness or a hip
fracture are more at risk of delirium. We have developed a
care bundle for identifying and caring for people with delirium and
it is being piloted within NHS boards in Scotland.
Delirium is a medical emergency and carries a high level of
mortality. The prevalence of delirium in people on medical wards in
hospital is about 20% to 30%, and 10% to 50% of people having
surgery develop delirium. Evidence shows that people who have
delirium may need to:
- stay longer in hospital or in critical care,
- have an increased incidence of dementia,
- have more hospital-acquired complications, such as falls and
- be more likely to need to be admitted to long-term care if they
are in hospital,
- be more likely to die.
Taking a collaborative approach to improving care
Working together is the key to improving care for older people.
This workstream engages with healthcare teams from acute hospitals
across Scotland, coming together for a series of events and webex
- introduce new tools for testing locally with the aim of
improving screening for frailty and improving the early management
- share experience, expertise and examples of good practice in
improving care for older people
- build capacity and capability for improvement
- support local improvement work.