One Stop Geriatric Care in the A&E
Care Process & Redesign
Workforce Transformation
National Healthcare Innovation and Productivity Medals
National Healthcare Group
31 December 2021
To ensure better care for geriatric patients in the Acute and Emergency Care Centre (A&E) by avoiding unnecessary admissions. AGAU demonstrated significant savings, improved care efficiency, and enhanced geriatric patient outcomes.
Year Submitted: 2021
Published Date: 31 December 2021
Tags: Care Process ＆ Redesign, Workforce Transformation, Quality Improvement, Job Effectiveness, Productivity, Cost Saving, Access To Care, Bed Occupancy Rate, Value Based Care, Utilisation, Job Redesign, Upskilling, Multi-Disciplinary
About this Content
Aims
To ensure better care for geriatric patients in the Acute and Emergency Care Centre (A&E) by avoiding unnecessary admissions.
Background
Geriatric patients represent 25.7% of admissions but only 10.7% of attendances. Unnecessary inpatient admissions create avoidable costs and strain resources.
Methods
Implemented the Acute Geriatric Care Unit (AGAU) with a multidisciplinary team to assess borderline admission cases, provide care, and support safe discharges.
Results
966 patients admitted to AGAU: 70.5% (681) discharged, saving 5,312 bed days ($3,452,670). Patient costs reduced by 62% ($413 vs $1,096 for 3-day inpatient stays). Referrals to Community Care increased by 146%.
Conclusion
AGAU demonstrated significant savings, improved care efficiency, and enhanced geriatric patient outcomes. Safe discharges reduced unnecessary admissions.
Lessons Learnt
Fast and small-scale implementation (4-bedded unit) resolved teething issues like referrals and rounding conflicts. Collaboration fostered mutual learning and communication among teams.
Additional Information
Initiative remains operational post-COVID. GEM nurses provide opportunistic screening for frailty and falls risk.
Keywords
Care Redesign, Geriatric Care, Emergency Medicine, Cost Savings, Bed Day Savings, Multidisciplinary Teams, Patient Safety, AGAU, KTPH
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Khoo Teck Puat Hospital |
Platform(s) | National Healthcare Innovation and Productivity Medals |
Healthcare Professional Group(s) | Allied Health, Nursing, Medical |
Applicable Specialty or Discipline | Geriatric Medicine, Physiotherapy |
Project Lead(s) | Adriel Rao Kailing |
Project Member(s) | Harold Lo Wui Foh |
Connect with this contributor!
Dr Adriel Rao Kailing - rao.adriel.k@ktph.com.sg
Project Attachment
370_KTPH_NHIP_2021_One_Stop_Geriatric_Care_in_the_AnE_COMBINED.pdf