Simulating a frailty assessment unit
This project has modelled the impacts of a dedicated unit for frail patients, and made recommendations based on a proven configuration.
Royal Cornwall Hospitals NHS Trust are working with the Acute Frailty Network to improve emergency care for frail older people. They also want to reduce the number of frail people in hospital and make the experience better for those who are admitted.
By providing specialist staffing and a bespoke clinical environment, a frailty assessment unit was suggested as a method of achieving these goals in the future. Joe Turner, an Information Analyst at the Trust, joined the HSMA programme to help underpin this decision with evidence.
Based on a year of admissions data, Joe worked with his HSMA mentor to create a model of the number of beds needed for frail patients. The model included emergency admissions and used a method called discrete event simulation; breaking down the way a system works into a series of small and related events.
This simulation allowed Joe to capture data on how bed occupancy would change throughout a typical year, both on the proposed frailty assessment unit and the existing medical assessment units. It also provided a robust insight into the percentage of these patients who would meet the 4 hour waiting time standard.
The results showed that a frailty assessment unit could reduce pressure on the standard accident and emergency system and if optimised correctly, would mean 94% of frail patients wait less than 4 hours in the emergency department.
The model also allowed Joe to explore other options, such as using the frailty beds for other short-stay patients when capacity is available, and changes to the size of the medical assessment unit.
By helping the Trust identify the resources needed to run an efficient and effective frailty unit, this project has provided information that can feed into future business plans. It has also developed a resource that can be used to re-assess these numbers when the Trust is ready to implement the new unit.