Comprehensive Geriatric Assessment On A New Specialist Geriatric Ward In A Post-Acute Rehabilitation Setting: A Retrospective Review

Abstract

Background Older adults with complex care needs should receive a comprehensive geriatric assessment (CGA) in line with the National Clinical Programme for the Older Person recommendations1. The review evaluated integrated multidisciplinary team (MDT) requirements for all admissions, over one year period, on a new Specialist Geriatric Ward (SGW), in a post-acute rehab setting, with frailty screening on admission indicating complexity and MDT input. Methods A retrospective analysis was conducted on all patients admitted onto a SGW in 2024. Outcome measures reviewed included Barthel Index (BI), Functional Independence Measure (FIM) scale in eight activities of daily living, Elderly Mobility Score (EMS) and Functional Oral Intake Scale (FOIS) on admission and discharge. Patients were cohorted by Clinical Frailty Scale (CFS). Referrals to Medical Social Work (MSW), Dietetics and Speech and Language Therapy (SLT) were analysed. Results Medical, nursing, occupational therapy, physiotherapy and pharmacy reviewed all patients (n=217). Mean age was 82.9 years and mean length of stay (LOS) was 45.6 days in 2024. From admission to discharge, the median improvement was 1 point in BI and 4 points in the FIM. The median EMS on admission was 11, improving to 17 on discharge. MSW contributed to 99% (n=215) of CGAs, 174 patients required discharge co-ordination and referral to formal supports. 22 patients required assistance for nursing home application process. Dietetics contributed to 73% (n=159) of CGAs, 23 referrals from a new sarcopenia pathway. SLT contributed to 30% of CGAs (n=64), 35 referred for swallow assessment, 8 referrals for communication assessment, 15 referrals for both and 4 patients requiring Instrumental assessments. Mean FOIS score on admission and discharge was 6. Conclusion CGA on a post-acute SGW was associated with meaningful functional improvements across a spectrum of CFS scores. These findings highlight the value of an integrated MDT in enhancing recovery of older adults.