3505 A quality improvement project examining standards of advance care planning and outcomes of fast track discharges

Abstract Introduction The British Geriatrics Society promotes Advanced Care Planning (ACP) for patients in their last year of life, reducing avoidable admissions; empowering them to make informed decisions; and helping them plan for their future care to align with personal values and goals. This Quality Improvement Project (QIP) aimed to investigate ACP documentation and the outcome of Fast-Track (FT) discharges in accordance with the EoL care strategy 2008. Method The first QIP cycle was completed by analysing the FT discharges between March 2023 and March 2024 from an Acute Frailty Unit. 51 patients were included. Data were collected from their electronic health records and were analysed using Microsoft Excel and Jamovi. Results The mean age of the patients was 84.96 years; the mean Clinical Frailty Score (CFS) was 6.1 with 72.5% of patients having a CFS greater than 5 (37/51). ACP was discussed and documented in 78.4% (40/51) of patients. 22% (11/51) did not have documented ACP. 54.9% (28/51) were FT to a Nursing Home, with 33.3% (17/51) FT to their own homes. 7.8% (4/51) of patients were readmitted within 30 days of discharge. 11.8% (6/51) of patients died in the hospital while awaiting FT discharge. 56.9% (29/51) died in the community, and 31.4% (16/51) remained alive at data collection. Of the 51 patients, 2% (1/51) were readmitted; 2% (1/51) had an Emergency Department (ED) attendance but were not admitted; 4% (2/51) attended an outpatient appointment, and 80% (41/51) did not return to the hospital. Based on the age profile, we would expect 9% to die, 15% to readmit, and 8% to return to the ED without admission within 30 days. Conclusion ACP discussions result in low readmission rates and ED visits demonstrating better patient outcomes, avoidance of unnecessary admissions, and reduced costs. The second cycle has been commenced.