GUH Frailty at the Front Door Service helps 2,200 older people to avoid lengthy hospital stays

Patient Kathleen O Sullivan in her home in Galway with GUH Frailty Team’s Therapy Assistant, Patricia Duffy.

Galway University Hospitals’ Frailty at the Front Door Service has helped more than 2,200 older people avoid lengthy hospitals stays since its inception.

Launched in 2021 the FFD service provides older patients with targeted interventions and assessments to help them avoid hospital stays.

Patients aged 75 and over who present at the emergency department are helped by a team of Physiotherapists, Clinical Nurse Specialists, Occupational Therapists and Geriatricians.

Most of these patients who present with frailty will be arriving after a fall or because of changes in a patient’s ability to complete everyday tasks.

The service uses a holistic and multi-disciplinary approach to help frail patients to avoid a hospital stay by intervening at the earliest point in the patient’s journey, that is, at the front door in the Emergency Department.

Many older patients express a preference to recover from a health set back in their own home and a large part of the FDD service involves supporting the patient with a safety net of clinical services when they are discharged from the Emergency Department.

This has become increasingly important for keeping the emergency department moving, as the number of patients over the age of 75 presenting has increased by 25% since 2019.

Kathleen O Sullivan from Galway was referred to the Frailty team recently after she became unwell, her son Ultan describes the service as a hugely positive experience.

“The FDD team showed unbelievable compassion, respect, patience and understanding to my Mum and her needs.”

“Prior to Mum arriving home from hospital, the Frailty therapists came to her home to assess the space and to see what equipment would be required to allow her recover from her set back.”

Ultan has praised the Frailty team for their efficiency and professionalism but more importantly for fully consulting with him as Kathleen’s main carer.

“During my Mum’s recovery, the team made several visits to her home to monitor her progress, to give support and advice. In addition, they reached out to other local community services such as PHN, Home Help and Physio Services.”

“As a direct result of the Frailty Team’s interventions, together with the other great local health services, Mum has made a full recovery and regained her independence to continue to live with dignity in her own home.”

Some of the key aspects of the FDD service are continuity of care and follow up, this year the Frailty team has supported discharge directly to home in over 60% of frailty cases presenting to the Emergency Department.

This involves working with colleagues in Galway’s Integrated Care Programme for Older Persons to ensure that patients can safely recover at home with access to the appropriate clinical specialists should they need it.

Orla Sheil is Senior Occupational Therapist in the FDD service, she describes some of the work carried out by the team.

“Early assessment means we find out what’s important to our patients and what their needs are and early intervention means we find ways to support their safe recovery at home.”

“This approach has really significant outcomes both in terms of patient flow in the hospital setting leading to shorter length of stay and also enhances mobility, recovery and independence for our frailty patients.”