Article Figures & Data
Figures
- Fig 1.
Thematic analysis of survey free-text comments regarding barriers to identifying frailty in hospital. ECOG = Eastern Cooperative Oncology Group; MDT = multidisciplinary team
Tables
Characteristic Number of responders (%) Clinician grade Consultant 181 (45) Junior doctor 96 (24) Specialty trainee 77 (19) No response 48 (12) Current specialty Geriatric medicine 88 (22) Acute medicine 68 (17) No response/unable to categorise 42 (10) Specialist surgical specialties 28 (7) Gastroenterology 23 (6) Anaesthetics 20 (5) Respiratory medicine 20 (5) Emergency medicine 17 (4) Critical care 11 (3) Community medicine 10 (2) General surgery 10 (2) Renal medicine 10 (2) Cardiology 9 (2) Rheumatology 9 (2) Diabetes and endocrinology 6 (2) Neurology 6 (2) Palliative medicine 5 (1) Psychiatry 5 (1) Other (infectious diseases, microbiology, dermatology, haematology, paediatrics, chemical pathology, radiology) 15 (4) Current place of work Salford Royal NHS Foundation Trust 113 (28) Western Sussex Hospitals Foundation NHS Trust 66 (16) No response/not specified 62 (15) East Lancashire Hospitals NHS Trust 61 (15) Pennine Acute Hospitals NHS Trust 32 (8) Central Manchester University Hospitals NHS Foundation Trust 18 (4) Blackpool Teaching Hospitals NHS Foundation Trust 11 (3) Pennine Acute NHS Hospitals Trust 8 (2) University Hospitals of Morecambe Bay NHS Foundation Trust 7 (2) Bolton NHS Foundation Trust 3 (1) University Hospital of South Manchester NHS Foundation Trust 3 (1) Portsmouth Hospitals NHS Trust 2 (0.5) Royal Berkshire NHS Foundation Trust 2 (0.5) Stockport NHS Foundation Trust 2 (0.5) Other (list available on request) 12 (3) Survey statements Agree, n (%) Disagree, n (%) Not sure, n (%) No response, n (%) 1. Personal understanding of ‘frailty’ a) I fully understand the meaning of the clinical term ‘frailty’ 209 (52.0) 76 (18.9) 110 (27.4) 7 (1.7) b) I use the term ‘frailty’ in my clinical practice, but am uncertain of its definition 147 (36.6) 220 (54.7) 20 (5.0) 15 (3.7) c) I am unsure what ‘frailty’ means 98 (24.4) 243 (60.4) 42 (10.4) 19 (4.7) 2. Identification of frailty a) As part of my training, I have been taught how to identify frailty 128 (31.8) 226 (56.2) 26 (6.5) 22 (5.5) b) I feel confident identifying frailty 213 (53.0) 99 (24.6) 66 (16.4) 24 (6.0) c) I frequently describe patients as frail 204 (50.7) 155 (38.6) 19 (4.7) 24 (6.0) d) I rely on clinical judgement to identify frailty 292 (72.6) 63 (15.7) 23 (5.7) 24 (6.0) e) I use frailty assessment tools to identify frailty 98 (24.4) 257 (63.9) 22 (5.5) 25 (6.2) f) The presence/absence of frailty affects my clinical decision making 318 (79.1) 28 (7.0) 31 (7.7) 25 (6.2) 3. Assessments for frailty: a) Are best done in the community 160 (39.8) 100 (24.9) 106 (26.4) 36 (9.0) b) Should be undertaken for all older people admitted to hospital 298 (74.1) 27 (6.7) 41 (10.2) 36 (9.0) c) In hospital: should be the responsibility of geriatricians only 25 (6.2) 312 (77.6) 31 (7.7) 34 (8.5) d) In hospital: should be the responsibility of all clinicians 316 (78.6) 27 (6.7) 26 (6.5) 33 (8.2) e) In hospital: should be the responsibility of nursing staff 255 (63.4) 60 (14.9) 50 (12.4) 37 (9.2) f) In hospital: should be the responsibility of therapy staff e.g. physiotherapy, occupational therapy 270 (67.2) 45 (11.2) 51 (12.7) 36 (9.0) g) It is currently feasible to assess all older people admitted to hospital for frailty 144 (35.8) 122 (30.3) 102 (25.4) 34 (25.4) 4. Management of frailty a) All hospital inpatients identified as frail should be reviewed by a geriatrician 176 (43.8) 115 (28.6) 72 (17.9) 39 (9.7) b) It is feasible for all inpatients identified as frail to be reviewed by a geriatrician 47 (11.7) 219 (54.5) 96 (23.9) 40 (10.0) c) Inpatients identified as frail are best managed on dedicated frailty units 157 (39.1) 101 (25.1) 102 (25.4) 42 (10.4) d) Inpatients identified as frail are best managed by geriatricians 203 (50.5) 77 (19.2) 80 (19.9) 42 (10.4) 5. Education I would like more teaching on the identification and management of frailty 273 (67.9) 53 (13.2) 39 (9.7) 37 (9.2)
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