RT Journal Article
SR Electronic
T1 Embedding comprehensive geriatric assessment in the emergency assessment unit: the impact of the COPE zone
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 19
OP 24
DO 10.7861/clinmedicine.16-1-19
VO 16
IS 1
A1 Joanne K Taylor
A1 Oliver S Gaillemin
A1 Amy J Pearl
A1 Sean Murphy
A1 Jennifer Fox
YR 2016
UL http://www.rcpjournals.org/content/16/1/19.abstract
AB We introduced a geographically embedded frailty unit, the comprehensive older person’s evaluation ‘COPE’ zone within our emergency assessment unit (EAU). We collated data for all medical patients over 75 years admitted non-electively for one month before and after this service change. Significantly more patients were seen by a geriatrician on the EAU earlier in their admission in 2014 (33.4 vs 19.3%, p<0.001; 11 vs 20 h, p<0.001). More patients had documented comprehensive geriatric assessment and discussion in a geriatrician multidisciplinary team meeting (relative risk (RR) 3.3, 95% confidence interval (CI) 2.35–4.73, p<0.001; RR 3.6, 95% CI 2.26–5.57, p<0.001, respectively). More patients with markers of frailty were discharged directly from EAU (42.2 vs 29.0%, p = 0.006) without increasing readmissions. Mean length of stay was reduced (9.5 vs 6.8 days, p = 0.02). The introduction of the COPE zone has improved service delivery at the point of access for older people admitted to hospital.