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173 cases identified. Median age 87 (92

82) years old, 74.4%

female, Clinical Frailty Scale 6 (6

4), Cumulative Illness Rating Scale-

Geriatrics 10 (14

6), 55.6% living alone. 51.1% of patients presented

with falls. Although Glasgow Admission Prediction Score anticipated

hospitalisation in 78.7% of cases, only half of these were admitted,

and in total 56.6% were discharged home. Furthermore, prospective

monitoring showed that 52.2% remained at home 7 days after

discharge and 41.7% at 28 days. Patients requiring admission had

more polypharmacy (p = .038) and higher risk of pressure ulcers

(p = .008). Mortality was extremely low (1.7%) and occurred in the first

7 days of admission.


This study shows that it is possible to deliver CGA to frail

elderly patients attending a busy ED. Despite patient complexity,

frailty severity, and social context, this intervention managed to

decrease by half predicted hospital admission and may have con-

tributed to reduce attendance. Patients requiring admission are not

significantly different from their counterparts, which reiterates that

care provision in EDs should remain patient-centered.


Geriatric consultation project in Austrian provincial nursing


P. Mrak


, F. Hasandic


, P. Krippl


, W. Habacher


, T. Augustin



W. Lerchbacher


, B. Zirm


, M. Siebolds




LKH-Voitsberg, Voitsberg,


LKH-Feldbach-Fürstenfeld, Fürstenfeld,


Joanneum Research-Health/

EPIG, Graz,


LKH-LPZ Radkersburg, Bad Radkersburg, Austria;


Katholische Hochschule, Köln, Deutschland


Nursing Home (NH) residents experience a high number

of transfers from nursing facilities to the hospital, many of them

unnecessary, sometimes harmful and always costly. The implementa-

tion of geriatric expertise and counseling in a Provincial Nursing Home

(LPZ) was intended to avoid unnecessary transportation and thus

prevent transfer trauma in terms of physical and emotional stress to

the highly vulnerable residents.


In 2014 we performed a controlled, prospective obser-

vational Study over a 6 month period comparing the two preceeding

years and evaluating the effects of structured knowledge transfer

and implementation of geriatric expertise, comprehensive geria-

tric assessement (CGA), geriatric counseling to practitioners and

hospitalists as well as nursing home staff in the LPZ versus care as


82 nursing home residents(LPZ) were included for intervention,

medium age 81.7 ± 11.7; CGA: Barthel index (ADL) 36,1 ± 29.1;

Esslinger Transfer scale 2.2 ± 1.8; MNA (shortform) 10.5 ± 2.6.

We used the Geriatric Case Conference-Method (PFK) for geriatric

knowledge transfer in periodic sessions during the study period.


We saw a clear reduction in the number of transports to the

hospital (7.9, 9.2 vs 5.4/pat./y) and less outpatient contacts (299.2,

373.0 vs 198,9/per 100 pat/y) of NH residents in the interventional

LPZ compared to the 2 years ahead. On the contrary admissions to

the hospital (70.8, 68,4 vs 97,8 per 100 pat/y) have risen during

intervention. Satisfaction among caregivers- doctors and nurses did

clearly improve.


Bilateral Knowledge transfer (PFK) and structured imple-

mentation of geriatric expertise (CGA, Counseling) in nursinghomes

and between all multidisciplinary caregivers involved, can reduce

avoidable transportation trauma to residents and thus improve quality,

continuity and satisfaction of care.


Multidisciplinary management for multifactorial falls: a quality

improvement project in assessment for geriatric patients

presenting with fall to the emergency department

E. Nally, A. Frater, S. Saber, R. Mizoguchi.

Royal Free London NHS

Foundation Trust, United Kingdom


Falls are one of the commonest causes for geriatric

patients to present to the emergency department (ED). TREAT

(Triage Rapid Elderly Assessment Team) is a specialised geriatric

service which aims to assess and manage patients within the ED

thereby facilitating safe discharge. We aim to identify if guideline

care is being met and to seek alternative approaches to overcome

the challenges faced in assessing falls patients within the emer-

gency setting.


We identified 27 patients aged over 80 from the TREAT

database, who presented two or more times with a fall-related

complaint to ED within 6 months. A standard for assessment was

identified from the NICE guidelines and British Geriatrics Society

(BGS) Silverbook.


As stated in NICE guidelines and BGS Silverbook, we focused

on various aspects as below. 27 patients presented 59 times within a 6

month period. Of 59 presentations, 15% (n = 9) had no witness history

and 54% (n = 32) had no recorded postural blood pressure. On the other

hand 100% (n = 59) had bloods tests, 97% (n = 57) had an electro-

cardiogram (ECG), 93% (n = 55) had a documented abbreviated mini

mental test score (AMTS). 52% (n = 14) had a 24-hour ECG and

echocardiogram within 1 year.


In summary some of the recommended basic assess-

ments were not performed. On the contrary, despite investigation

patients with falls still presented to ED repetitively. We recognise the

requirement of a proforma available to the multidisciplinary team to

allow a multifactorial assessment within the ED.


National benchmarking figures of inpatient falls per 1,000

occupied bed days (OBDs) in England and Wales

R. Schoo


, N. Vasilakis


, R. Stanley


, F. Martin


, S. Rai


, S. O





Royal College of Physicians (RCP), London, United Kingdom


Falls in hospital are the most commonly reported

patient safety incidents. They can result in serious injuries, slower

recovery and increased costs.


The National Audit of Inpatient Falls (NAIF) collected

hospital reported rates of falls and falls that caused injuries during


Numbers of falls were converted to falls per 1000 OBDs and falls

resulting in moderate harm, severe harm or death per 1000 OBDs.


For the first time we have the falls rates across both countries,

with 96% of eligible hospital trusts participating.

Falls per 1,000 OBDs:

mean: 6.52

range: 3.11


interquartile range (IQR): 5.48


Falls resulting in moderate harm, severe harm or death per 1,000


mean: 0.18

range: 0.03


IQR: 0.11


Key Conclusions:

Trusts can now, for the first time, benchmark against

national averages.

Some limitations on the ability to benchmark are:

Trust composition: some trusts include only acute hospitals, while

others combine acute hospitals, community hospitals and mental

health units.

Patient demographics: rates of falls will be affected by differences

associated with patient casemix. A higher falls rate may indicate

more vulnerable patients. Length of stay may also influence falls


Reporting practices: A higher reported falls rate may indicate

better reporting practices. Very low rates may indicate a poor

culture of defining or reporting falls. For this reason falls result-

ing in moderate harm, severe harm or death were also cal-

culated as falls resulting in injury are more likely to be accurately


Poster presentations / European Geriatric Medicine 7S1 (2016) S29