Acute Bed Avoidance, Direct Admissions from Frailty at the Front Door to Rehabilitation Beds in Partnership with the ICPOP Team

Abstract Background A key priority outlined in the Programme for Government is to support older people to live in dignity and independence in their own home. In line with the Slainte care vision for easier access of Right Care, Right Place and Right Time Clontarf Hospital have developed a pathway with the ICPOP Team/ FITT Team admitting patients directly from the front door of the acute hospital into a more appropriate environment, thus avoiding Acute Hospital admission or admitting directly from the community thus avoiding the Emergency Department presentation. The patients are over 65 years of age with multi comorbidities and complexities. Methods Both pathways have been developed and embedded. The ICPOP Consultant Geriatrician and the Patient Flow Teams in both Clontarf Hospital and the Mater Hospital collaborated to establish a seamless FITT to Rehab pathway which is person centred. At least 1 Rehabilitation bed is offered by Clontarf Hospital to the FITT ED Team 5 days a week Monday- Friday. An electronic communication group was instated to refer patients directly from the Emergency Department MMUH to Clontarf Hospital. The Comprehensive Geriatric Assessment Tool is utilised to refer and handover all patients. The data is collected on Clontarf Hospital Electronic Dash Board since the introduction of the service including: Source of admission Number of Admissions Age profile Length of Stay Discharge Destination Results Since the start of the service mid-2022, 174 patients have been admitted saving acute hospital bed days. The MLOS is 22 days and ALOS is 27 bed days. Over 72% of patients are discharged directly home. There has been significant positive feedback from patients and families. Conclusion The establishment of a direct admission pathway from the Emergency Department and the community to a rehabilitation hospital has demonstrated positive patient outcomes and overall benefits to the healthcare system.