The benefit of a frailty clinician in aiding triage within the emergency department to help eliminate corridor care
Introduction: ‘Corridor care’ in the NHS refers to providing medical care to patients in hospital corridors due to a lack of available clinical bed space. This often occurs during periods of increased demand, such as winter months or when there are delays in patient discharges causing bed blockages...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
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| Series: | Future Healthcare Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2514664525002127 |
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| Summary: | Introduction: ‘Corridor care’ in the NHS refers to providing medical care to patients in hospital corridors due to a lack of available clinical bed space. This often occurs during periods of increased demand, such as winter months or when there are delays in patient discharges causing bed blockages in the emergency department (ED). It highlights the increasing pressures within the NHS, including overcrowding, staff shortages and subsequent increased demand on stretched resources.Corridor care can negatively impact patient dignity and safety. Despite these issues, it provides a broader challenge in healthcare capacity and planning. Addressing it requires systemic improvements in hospital infrastructure, patient flow management and additional resources to ensure patients receive the quality of care they deserve in a safe and supportive environment.There is an ever-growing prevalence of frail older adults in the ED, who often, due to multiple chronic conditions, cognitive issues or reduced physical function, cause delays to decision-making and subsequently discharge. Therefore, early referrals to specialists and the use of frailty units can improve outcomes and increase discharges from the ED. Materials and methods: One such intervention was a trial of the addition of a frailty clinician joining the triage nurse when taking handovers from paramedics conveying patients to the ED. Here, the emphasis was early identification of suitable patients for referral to the frailty team direct from triage and transfer of these patients from ED to a dedicated frailty unit to decongest the ED corridor. The trial took place for 4 consecutive days (Tuesday–Friday) in August 2024 between 08:00 h and 16:00 h. Results: The average number of patients seen in the dedicated frailty unit increased from 7 daily to 13 daily during the trial.During the trial, there were no patients in the ED corridor between 08:00 and 16:00 h, compared with an average of five patients pre-trial (Figs 1 and 2).ED attendances were still at a baseline average of ∼220 patients during the trial similar to non-trial days, showing no data bias resulting from quieter ED days in terms of patient volume during the trial.On average, four patients were admitted and nine patients were discharged daily from the frailty unit during the trial. Conclusion: Data for admitting a >75-year-old patient show an average ED time of 20 h; therefore, 80 h were saved per day of patient time in ED during the trial.An average of 8 h for discharging a >75-year-old patient from ED equates to 72 h saved per day (SAPIT data >70-year-old).Therefore, a total of 152 h was saved per day in ED.If patients stay for an average of 4 h, this would equate to 38 fewer patients not in the ED per day.Eliminating corridor care is vital. Patients’ health is compromised when treated in corridors and is further exacerbated for our frail cohort for whom delays in timely interventions increase their risk of deterioration. Thus, frailty triage is our ambition with better staffing. By addressing both frailty and corridor care, the NHS can ensure safer and more efficient care for all patients, ultimately leading to improved health outcomes and reduced strain on the ED. |
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| ISSN: | 2514-6645 |