The Prevention and Reactivation Care Program: intervention fidelity matters
OBJECTIVE To analyze and describe the operational benefits that followed the introduction of a multiprofessional older person assessment and liaison service (OPAL) into the acute admissions areas of a general hospital. OPAL delivered comprehensive geriatric assessment and a range of early medical, nursing, therapy, and social interventions to all eligible elderly and frail patients. METHODS A mix of numeric data, case note narrative, historic comparison, and staff opinion was used to reach a reliable view of the impact that OPAL had on a number of key indicators pertaining to the timing of assessments, treatments, and discharge planning. RESULTS We found that the new service reduced the time required to achieve several critical interventions including medical, nursing, and therapy reviews. We were also able to show that OPAL activity played a critical role in reducing the length of hospital stay of frail older people and made available the equivalent of 9-16 beds per day (8%-14% of acute admission area beds). CONCLUSION OPAL was shown to be effective as a medium for timely review and intervention of frail elderly patients in an acute medical setting, and as a mechanism for reducing length of stay.