Calling all geriatricians… FRAILsafe needs you!!

Zoe Wyrko is pleased to announce the next phase of FRAILsafe, a new checklist for the acute care of frail older people.

Would you like to be involved in a national project which will change the way care is delivered to all frail older people, not just those who are able to be looked after by geriatricians on our specialist wards? Would you like to be part of work that will lead to improvements in the skills of all healthcare professionals who encounter vulnerable people in hospital? Would you like to see a reduction in the inadvertent harm caused when a frail older person needs to be admitted to hospital? If so …. read on.

I am pleased to announce that the FRAILsafe project has been successful in bidding for a Health Foundation ‘Closing the Gap in Patient Safety’ grant. A total of ten projects are being supported as part of the £4 million scheme, with the aim of supporting the implementation and evaluation of evidence-based patient safety interventions at scale. There were over 100 applications for the grants and the award represents a very significant achievement for the FRAILsafe team and a recognition that quality of care for older people is a priority at the Health Foundation.

The project is being led on behalf of the BGS by Tom Downes in Sheffield (read his previous blog here), and our partner organisations include NHS England, the Royal College of Physicians, and AgeUK. We are now at the exciting stage of being able to appoint experts in design and project management to further progress the work from it’s current stage. We are also pleased to be able to draw on the expertise of the NW London CLARHC who are supporting us with data collection and analysis.

Some of you will have heard me speak about FRAILsafe at recent BGS conferences, but for those who have not heard of the project before, we are aiming to:

“reduce harm to frail older people in acute hospital care through effective implementation of an evidence based checklist to improve communication and team working to support reliable and safe care.”

The tool has already been in development for a couple of years, and we have used quality improvement methodology to move from the very early stages of a single trial on a single patient (version 1), to a more wide-spread pilot phase taking place in 8 hospitals across England and Scotland in autumn 2013 (version 6). We have used principles embraced by the WHO surgical safety checklist to narrow down the aspects of the care of frail people which if not addressed, can rapidly lead to harm with associated poor outcomes.

Much debate has taken place about the importance of various geriatric giants, whilst remaining mindful that in order to be effective the tool must be simple, brief and not just another ‘piece of paper.’  What we have arrived at, we think, incorporates these principles where it is incorporated into routine practice as part of a “check and challenge” protocol to ensure that older patients are getting evidence-based best care.

In due course, we anticipate that FRAILsafe will be incorporated into whichever form of documentation a Trust uses, whether paper or electronic; and although the initial project work is around acute hospital admissions it is likely that the tool will be translatable into other environments. As with anything, there may also be an app for it…

So, if you are interested then please get in touch with me via email zoe.wyrko@uhb.nhs.uk. We are looking for 12 sites for the next phase of the project, beginning autumn 2014, and ideally would like a hospitals large and small throughout the 4 nations.  If you cannot be involved at this point, then please follow us @FRAILsafe and watch this space as regular updates will be provided.

We are grateful for the participation of the following people and trusts:

• Professor  Adrian Hopper –Guys and St Thomas’s Hospital London
• Dr Christine McAlpine-Glasgow Royal Infirmary
• Dr Sally Irwin-York Hospital
• Dr Tom Downes -Sheffield Teaching Hospital
• Dr Adam Gordon -Nottingham University Hospitals NHS Trust
• Dr Simon Conroy -University Hospitals of Leicester
• Dr John Soong-Chelsea and Westminster Hospital London
• Dr Alison Diack- Royal Liverpool and Broadgreen University Hospital Trust
• Dr Zoe Wyrko- University Hospitals Birmingham