Service provision for Frailty in European Emergency Departments (FEED): a survey of operational characteristics

Abstract

Background

The observational Frailty in European Emergency Departments (FEED) study found 40% of older people attending for care to be living with frailty. Older people with frailty have poorer outcomes from emergency care. Current best practice calls for early identification of frailty and holistic multidisciplinary assessment. This survey of FEED sites explores variations in frailty-attuned service definitions and provision.

Methods

This cross-sectional survey included study sites across Europe identified through snowball recruitment. Site co-ordinators (healthcare professionals in emergency and geriatric care) were surveyed online using Microsoft Forms. Items covered department and hospital capacity, frailty and delirium identification methods, staffing, and frailty-focused healthcare services in the ED. Descriptive statistics were reported.

Results

A total of 68 sites from 17 countries participated. Emergency departments had median 30 (IQR 21–53) trolley spaces. Most defined "older people" by age 65+ (64%) or 75+ (25%). Frailty screening was used at 69% of sites and mandated at 38%. Night-time staffing was lower compared to day-time for nursing (10 [IQR 8–14] vs. 14 [IQR 10–18]) and physicians (5 [IQR 3–8] vs. 10 [IQR 7–15]). Most sites had provision for ED frailty specialist services by day, but these services were rarely available at night. Sites mostly had accessible facilities; however, hot meals were rarely available at night (18%).

Conclusion

This survey demonstrated variability in case definitions, screening practices, and frailty-attuned service provision. There is no unanimous definition for older age, and while the Clinical Frailty Scale was commonly used, this was rarely mandated or captured in electronic records. Frailty services were often unavailable overnight. Appreciation of the variation in frailty service models could inform operational configuration and workforce development.

Metadata

Item Type:	Article
Authors/Creators:	Fehlmann, C.A. https://orcid.org/0000-0002-4163-0338 Mc Loughlin, K. Cosgriff, E.J. Ferrick, J.F. van Oppen, J.D. Coats, T. Conroy, S. de Groot, B. Heeren, P. Lim, S. Lucke, J. Mooijaart, S. Nickel, C.H. Penfold, R. Singler, K. Heeren, P. Steenebruggen, F. Sterckx, V. Brdar, I. Libicherová, P. Balen, F. Bianco, C. Dubucs, X. Guenezan, J. Apfelbacher, S. Fraidakis, O. Fyntanidou, V. Gaál, S. Jónsdóttir, A.B. Cremin, M. Kelly, M. McAteer, C. Moloney, E. Sankey, C. Sibthorpe, L. Zazzara, M.B. Camilleri, R.A. Zammit, P. Coffeng, S.M. Lucke, J. Smits, R. Bordigoni, M.A.R. Castejón-Hernández, S. del Rocio Coronel Chumbi, L. Mir, S.A. Padilla, E.E. Rojewski-Rojas, W. Fadini, D. Jegerlehner, N.S. Nickel, C.H. Zucconi, E. Demir, H.A. Dundar, Z.D. Güven, R. Karamercan, M.A. Kose, F. Söğüt, Ö Tayfur, I. Abbott, L. Adams, J. Bernardo, J. Brown, L. Burton, J. Claassen, R. Cooper, J. Heyes, R. Lightbody, C. Masoli, J. Mawhinney, D. McKenzie, S. Moultrie, N. Price, A. Raman, R. Rajasingam, A. Rothwell, L. Shashikala, R.P. Smith, E. Sorice, V. van Oppen, J. https://orcid.org/0000-0002-2570-7112 Wallace, J. Young, T.
Copyright, Publisher and Additional Information:	© The Author(s) 2024. Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Keywords:	Emergency care; Frailty; Delirium; Health services
Dates:	Published: 29 July 2024 Published (online): 29 July 2024 Accepted: 14 July 2024 Submitted: 11 January 2024
Institution:	The University of Sheffield
Academic Units:	The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health
Depositing User:	Symplectic Sheffield
Date Deposited:	07 Aug 2024 14:33
Last Modified:	02 Dec 2024 11:36
Status:	Published
Publisher:	Springer Science and Business Media LLC
Refereed:	Yes
Identification Number:	10.1186/s13049-024-01234-w
Related URLs:	Dataset Erratum/Corrigendum
Open Archives Initiative ID (OAI ID):	oai:eprints.whiterose.ac.uk:215696