3173 Standardised admissions proforma improves patient-focused care and reduces length of stay

Introduction Our district general hospital utilises an unselected medical receiving model where generic admission clerk-ins often miss salient information vital for comprehensive geriatric assessment (CGA). Recent Healthcare Improvement Scotland guidelines outlined people living with frailty that are admitted to an acute hospital are at risk of adverse outcomes. A standardised proforma for admissions to our medicine of the elderly (MOE) ward (clinical frailty score over five required for admission) would ensure critical information was collated for more effective CGA, decision making and discharge planning. The aim was by November 2024, 90% of inpatients within our acute MOE ward would have had complete admission proformas documented. Method We analysed information from generic medical admission notes and identified key items often omitted such as escalation status, medication review and discharge planning goals. We created a standardised MOE admission proforma which was piloted (cycle 1) and then incorporated into the electronic patient record (cycle 2). The outcome measure was the percentage of MOE patients with complete admission proformas. We also reviewed average length of stay data and sought feedback from ward staff. Results Baseline data revealed 57.2% of MOE patients had key CGA information documented on admission. Cycle one (July 2024) illustrated an increase to 74.1% meanwhile cycle two (November 2024) increased to 90.8%. There was a 25% reduction in average length of stay from 12.8 days to 9.6 days. Feedback from users of the standardised proforma was universally positive. Conclusion This proforma established a standardised patient-centred methodology for initial MOE patient assessment by ensuring medication reconciliation, improved comprehensiveness of clinical documentation and streamlining multidisciplinary team assessment to provide effective continuity of care and discharge planning. This was well received by users and resulted in patients returning home sooner. This proforma will be re-audited in 4 months and applied to other MOE wards.