SAFE: Systematic Approach to improving care for Frail Elderly patients

Much recent attention has focused on the problem of older people being treated in overcrowded emergency departments. Studies have clearly demonstrated an association between hospitalisation in older people and poorer outcomes, including loss of independence, admission to long-term care and mortality. Frailty, a state of increased vulnerability resulting from aging-associated decline in reserve and function, increases susceptibility to these effects. Recent national strategy documents relating to care of older people and emergency department management have stressed the importance of alternative models of care for frail elderly patients which prevent complications by avoiding or reducing hospital admissions where possible and support patients in the community enabling them to live independently for longer.
Here, we aim to explore current problems with care pathways for older people presenting to acute hospitals. A best practice pathway for care of frail elderly in acute hospitals will be developed. Substantial input for this will come from a patient and public involvement group who will ensure that patient priorities and perspectives will drive the development of the care pathway ensuringthat this model of care will achieve outcomes that areimportant to patients/families.
Even the best pathway will be of no benefit if it is not implemented. Here we outline an innovative approach to ensuring the new pathways are fit for purpose and will be able to be fully employed in clinical practice. During the process of development, each element of the new pathway will be tested in turn to ensure that patient-centred outcomes are being realised, continually refining the process of pathway development until a  workable model is achieved. This will ensure the resulting model of care is ready for implementation in the context of the Irish health service. It is envisaged that the full system will be implemented in St. Vincents University hospital 1 year following completion.


Award Date
15 September 2016
Award Value
Principal Investigator
Professor Marie Therese Cooney
Host Institution
University College Dublin
Applied Partnership Awards