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Service provision for Frailty in European Emergency Departments (FEED): a survey of operational characteristics: a survey of operational characteristics

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Title: Service provision for Frailty in European Emergency Departments (FEED): a survey of operational characteristics: a survey of operational characteristics
Authors: Christophe A. Fehlmann, Kara Mc Loughlin, Emma Jane Cosgriff, John Francis Ferrick, James David van Oppen, Timothy Coats, Simon Conroy, Bas de Groot, Pieter Heeren, Stephen Lim, Jacinta Lucke, Simon Mooijaart, Christian H. Nickel, Rose Penfold, Katrin Singler, Françoise Steenebruggen, Valerie Sterckx, Ivan Brdar, Pavla Libicherová, Frédéric Balen, Céline Bianco, Xavier Dubucs, Jérémy Guenezan, Stefanie Apfelbacher, Othon Fraidakis, Varvara Fyntanidou, Szabolcs Gaál, Anna Björg Jónsdóttir, Maria Cremin, Mary Kelly, Claire McAteer, Elizabeth Moloney, Ciara Sankey, Lisa Sibthorpe, Maria Beatrice Zazzara, Rene Alexander Camilleri, Paul Zammit, Sophie M. Coffeng, Rosalinde Smits, Miguel Alberto Rizzi Bordigoni, Santiago Castejón-Hernández, Lupe del Rocio Coronel Chumbi, Sira Aguiló Mir, Eduardo Enrique Padilla, Wojciech Rojewski-Rojas, Davide Fadini, Natalie Sabrina Jegerlehner, Enrico Zucconi, Hüseyin Avni Demir, Zerrin Defne Dundar, Ramazan Güven, Mehmet Akif Karamercan, Fulya Kose, Özgür Söğüt, Ismail Tayfur, Lucy Abbott, James Adams, Janice Bernardo, Leanne Brown, Joel Burton, Renate Claassen, Jamie Cooper, Ruth Heyes, Calvin Lightbody, Jane Masoli, David Mawhinney, Stephen McKenzie, Nicola Moultrie, Angeline Price, Rajendra Raman, Apirthan Rajasingam, Lauren Rothwell, Ravishankar Prabhakar Shashikala, Erica Smith, Vittoria Sorice, James van Oppen, James Wallace, Tom Young, Effie Polyzogopoulou, Lluís Llauger
Contributors: Fehlmann, Christophe A.§0000-0002-4163-0338, ULRR
Source: Scand J Trauma Resusc Emerg Med
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 32, Iss 1, Pp 1-6 (2024)
Publisher Information: Springer Science and Business Media LLC, 2024.
Publication Year: 2024
Subject Terms: Male, emergency care, Frail Elderly/statistics & numerical data, Frail Elderly, 1110 Nursing, frailty, FOS: Health sciences, 03 medical and health sciences, delirium, 0302 clinical medicine, Geriatric Assessment/methods, Surveys and Questionnaires, 80 and over, Humans, health services, European Taskforce for Geriatric Emergency Medicine, Geriatric Assessment, Original Research, Aged, Aged, 80 and over, Emergency Service, Science & Technology, Frailty, Hospital/statistics & numerical data, RC86-88.9, 3202 Clinical sciences, Health sciences, Delirium, 1103 Clinical Sciences, Medical emergencies. Critical care. Intensive care. First aid, Health services, 3. Good health, Europe, Frailty/diagnosis, Cross-Sectional Studies, Emergency Medicine, Female, Emergency care, Emergency Service, Hospital, Life Sciences & Biomedicine
Description: Background The observational Frailty in European Emergency Departments (FEED) study found 40% of older people attending for care to be living with frailty. Older people with frailty have poorer outcomes from emergency care. Current best practice calls for early identification of frailty and holistic multidisciplinary assessment. This survey of FEED sites explores variations in frailty-attuned service definitions and provision. Methods This cross-sectional survey included study sites across Europe identified through snowball recruitment. Site co-ordinators (healthcare professionals in emergency and geriatric care) were surveyed online using Microsoft Forms. Items covered department and hospital capacity, frailty and delirium identification methods, staffing, and frailty-focused healthcare services in the ED. Descriptive statistics were reported. Results A total of 68 sites from 17 countries participated. Emergency departments had median 30 (IQR 21–53) trolley spaces. Most defined "older people" by age 65+ (64%) or 75+ (25%). Frailty screening was used at 69% of sites and mandated at 38%. Night-time staffing was lower compared to day-time for nursing (10 [IQR 8–14] vs. 14 [IQR 10–18]) and physicians (5 [IQR 3–8] vs. 10 [IQR 7–15]). Most sites had provision for ED frailty specialist services by day, but these services were rarely available at night. Sites mostly had accessible facilities; however, hot meals were rarely available at night (18%). Conclusion This survey demonstrated variability in case definitions, screening practices, and frailty-attuned service provision. There is no unanimous definition for older age, and while the Clinical Frailty Scale was commonly used, this was rarely mandated or captured in electronic records. Frailty services were often unavailable overnight. Appreciation of the variation in frailty service models could inform operational configuration and workforce development.
Document Type: Article
Other literature type
File Description: application/pdf; text
Language: English
ISSN: 1757-7241
DOI: 10.1186/s13049-024-01234-w
DOI: 10.48620/88140
DOI: 10.34961/researchrepository-ul.26644579
DOI: 10.34961/researchrepository-ul.26644579.v1
Access URL: https://pubmed.ncbi.nlm.nih.gov/39075591
https://doaj.org/article/e529ca0c0e2a4627bc235276a81ec67b
https://research.rug.nl/en/publications/989285a2-eb5e-4784-87f9-3dced259e16a
https://doi.org/10.1186/s13049-024-01234-w
https://hdl.handle.net/11370/989285a2-eb5e-4784-87f9-3dced259e16a
https://hdl.handle.net/10344/13688
https://doi.org/10.34961/researchrepository-ul.26644579
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  Data: Scand J Trauma Resusc Emerg Med<br />Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 32, Iss 1, Pp 1-6 (2024)
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  Data: Background The observational Frailty in European Emergency Departments (FEED) study found 40% of older people attending for care to be living with frailty. Older people with frailty have poorer outcomes from emergency care. Current best practice calls for early identification of frailty and holistic multidisciplinary assessment. This survey of FEED sites explores variations in frailty-attuned service definitions and provision. Methods This cross-sectional survey included study sites across Europe identified through snowball recruitment. Site co-ordinators (healthcare professionals in emergency and geriatric care) were surveyed online using Microsoft Forms. Items covered department and hospital capacity, frailty and delirium identification methods, staffing, and frailty-focused healthcare services in the ED. Descriptive statistics were reported. Results A total of 68 sites from 17 countries participated. Emergency departments had median 30 (IQR 21–53) trolley spaces. Most defined "older people" by age 65+ (64%) or 75+ (25%). Frailty screening was used at 69% of sites and mandated at 38%. Night-time staffing was lower compared to day-time for nursing (10 [IQR 8–14] vs. 14 [IQR 10–18]) and physicians (5 [IQR 3–8] vs. 10 [IQR 7–15]). Most sites had provision for ED frailty specialist services by day, but these services were rarely available at night. Sites mostly had accessible facilities; however, hot meals were rarely available at night (18%). Conclusion This survey demonstrated variability in case definitions, screening practices, and frailty-attuned service provision. There is no unanimous definition for older age, and while the Clinical Frailty Scale was commonly used, this was rarely mandated or captured in electronic records. Frailty services were often unavailable overnight. Appreciation of the variation in frailty service models could inform operational configuration and workforce development.
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