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ACEM Spring Symposium
ACEM Spring Symposium
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Raising ED clinicians’ awareness of the importance of measuring frailty in geriatric trauma patients in a major trauma emergency department – A quality improvement project

Presentation Description

Frailty has been shown in multiple studies to be a predictor of mortality, complications, and discharge disposition after major trauma (1–3). The clinical frailty scale (CFS) has a strong predictive ability in the emergency department (ED) and could be used to improve care (4–8). 
There is evidence to suggest there is relatively low awareness amongst trauma providers around frailty assessment. Potential barriers include a lack of training and time to undertake the assessment (9).
This project aims to raise awareness amongst ED clinicians of the importance of measuring frailty in geriatric trauma patients in our emergency department. 
‘Plan do study act’ cycles will be utilised (10). The authors will audit the use of the CFS in elderly trauma assessments in the ED prior to and between each ‘intervention.’ Interventions will include RMO teaching sessions and an article in the monthly newsletter. 
Prior to the first intervention, two months worth of data showed CFS score was not documented in the ED assessment note for any patient who was later given a score by the trauma nursing team. This unfortunately did not improve following a single teaching session done at the weekly teaching. 
It is clear raising awareness within the department will require a variety of interventions. The authors hope, if selected to present, they will be able to demonstrate the barriers and hopefully change following further interventions. 
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2.        Zhao F, Tang B, Hu C, Wang B, Wang Y, Zhang L. The impact of frailty on posttraumatic outcomes in older trauma patients: A systematic review and meta-analysis. J Trauma Acute Care Surg [Internet]. 2020 Apr 1 [cited 2022 Feb 24];88(4):546–54. Available from:
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7.        Hamidi M, Haddadin Z, Zeeshan M, Saljuqi AT, Hanna K, Tang A, et al. Prospective evaluation and comparison of the predictive ability of different frailty scores to predict outcomes in geriatric trauma patients. J Trauma Acute Care Surg [Internet]. 2019 Nov 1 [cited 2022 Mar 27];87(5):1172–80. Available from:
8.        Lee JH, Park YS, Kim MJ, Shin HJ, Rho YH, Kim JH, et al. Clinical frailty scale as a predictor of short-term mortality: A systematic review and meta-analysis of studies on diagnostic test accuracy. Acad Emerg Med [Internet]. 2022 Mar 29 [cited 2022 Apr 14]; Available from:
9.        Shoultz TH, Moore M, Reed MJ, Kaplan SJ, Bentov I, Hough C, et al. Trauma Providers’ Perceptions of Frailty Assessment: A Mixed-Methods Analysis of Knowledge, Attitudes, and Beliefs. South Med J [Internet]. 2019 Mar 1 [cited 2022 Jul 18];112(3):159–63. Available from:
10.      The Health Foundation. Quality improvement made simple - What everyone should know about health care quality improvement. 2021 [cited 2022 Jan 19]; Available from: