Multidisciplinary interventions and outcomes of the Geriatric Faller Protocol in an emergency diagnostic treatment...

This is a descriptive review of the implementation of the Geriatric Faller Protocol (GFP) in the Department of Emergency Medicine (DEM) Emergency Diagnostic Treatment Unit, Singapore General Hospital, along with a post-implementation internal audit over a 6-month period from 1 July 2024 to 31 December 2024.

The clinical records of patients admitted to GFP during the 6-month period were retrospectively reviewed. Data of patients were collated under the categories: (a) sociodemographics and clinical profile, (b) medication profile, (c) injury profile, (d) non-pharmaceutical interventions, (e) pharmaceutical interventions and (f) intervention outcome measures.

Of the 115 patients admitted to GFP, 14 were excluded and 101 were included in the analysis (median age 81 years; 70.3% female). Most (79.2%) patients had a Clinical Frailty Scale of between 4 and 7. Acute hospital admission was avoided in 67.3% of cases; five reattended DEM within 30 days, of which only two were fall related. Falls were the primary reason for presentation (94.1%), with over half resulting in head or facial injuries. Polypharmacy was prevalent in 75% of patients (median number of medications: 9; interquartile range: 5-12), and 57.4% self-managed their medications.

Front-loading of assessments and interventions by a multidisciplinary team for patients under GFP suggested possible hospital admission avoidance and a reduction in short-term adverse outcomes.