Trauma Presentations To The ED, Are We Improving With Frailty Initiatives?

Abstract Background An emergency department serving as a regional Trauma Centre for the Midlands, now has a Rapid Access Frailty Team (RAFT) which provides timely assessments of all Frail patients over 75. The department has an approximate trauma attendance of 111 (2023 figures) annually within this age cohort. In line with our NOCA guidelines we performed a retrospective review of our trauma presentations since the introduction of the RAFT initiative, looking at the patient’s presentations and how interventions can improve our Trauma management. Methods This was a retrospective review of FRAIL positive patients in from January/February 2023 and January/February 2024 based on NOCA 2021 subsets of trauma data. Data was collected using examination of IPIMS and ED notes obtained for review. We compared both years to see we could see if RAFTT interventions improved our trauma triage and care. Results The predominant mechanism of injury remains to be a fall (85% in 2023 and 74% in 2024), and the majority of traumas being in the home setting (70% in 2023 and 78% in 2024). By the early involvement of a nurse specialist, physio/OT and doctor, time to be seen has reduced by 23% since the introduction of the team, time to imaging has improved by 51% and time to bed if admitted has improved by 19%. Pre alerts remain low, similar to national data findings (10% in 2023, but up to 15% in 2024). Conclusion Data points to the team’s provision of timely, patient-focused assessments and interventions for the older person are improving outcomes. The unique assessment skills that the team deliver aids rapid assessment, supports timely decision-making and referral as appropriate; improving the patient’s journey by either facilitating early discharge or providing early goal-setting therapy interventions at the start of the hospital journey.