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Project to improve A&E care for over 75s finds ‘room for improvement’ nationally

Wednesday 3 July

An RCEM project aiming to improve the care of older people in emergency departments has found “room for improvement” nationally.

The Quality Improvement Programme (QIP), titled ‘Care of Older People’ has compared the performance of 118 participating Emergency Departments against a set of RCEM standards which looked at care for patients aged 75 and older.

An interim report of the project, which is in its second year out of three, captured a ‘baseline’ level of care of older people in Emergency Departments using data taken between May and October 2023.

These measured the percentage of participating emergency departments that carried out a range of assessments including tests for delirium and risk of falls.

The report found “room for improvement across the board, in all standards” and recommended that the second year of the project focus on improving the detection and management of delirium, post-falls assessment, mitigating risk of falls and the regular monitoring of the needs of long-stay patients including nutrition, hydration and pain management.

Dr Adrian Boyle, President of RCEM said the project “provides a valuable opportunity to gain the first insights into the level of care being given to older and frail patients on a national level” and thanked the participating Emergency Departments for their collaboration.

Dr Anu Mitra, Project Leader said: “Older people constitute a cohort of Emergency Department patients which is growing in size, complexity and care needs and reflects a continuing demographic trend in all four nations.

“As a specialty whose workload reflects issues in the wider health and social care landscape, Emergency Medicine must accordingly meet the challenges of caring for older people at the front door.

“This national QIP has set a broad range of standards which cover both individual care and system design, to improve experience and outcomes for older people from the moment they enter the Emergency Department, using recognised quality improvement methodology and sharing of best practice.”

Read the full interim report here.

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