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115 Establishing the core elements of a frailty at the front door model of care using a modified real-time Delphi technique
  1. Íde O’Shaughnessy1,
  2. Damien Ryan2,
  3. Emer Ahern3,
  4. Patrick Harnett3,
  5. Christine Fitzgerald4,
  6. Katie Robinson4,
  7. Denys Shchetkovskyy2,
  8. Rose Galvin4
  1. 1Department of Occupational Therapy, University Hospital Limerick, Ireland
  2. 2Limerick EM Education Research Training (ALERT), Emergency Department, University Hospital Limerick, Ireland
  3. 3National Clinical Programme for Older People, Clinical Design and Innovation, Health Service Executive, Dublin, Ireland
  4. 4School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Ireland
  5. *denotes presenting author


Background Innovations in models of care for older adults living with frailty presenting to the emergency department (ED) have become a key priority for clinicians and researchers given the deleterious outcomes older adults experience due to prolonged exposure to such an environment. This study aimed to develop a set of expert consensus-based statements underpinning operational design, outcome measurement and evaluation of a Frailty at the Front Door (FFD) model of care for older adults within an Irish context.

Methods A modified real-time Delphi method was used. Facilitation of World Café focus groups with an expert panel of 86 members and an advisory group with a Patient and Public Involvement panel of older adults and members of the Irish Association of Emergency Medicine generated a series of statements on the core elements of the FFD model of care. Statements were analysed thematically and incorporated into a real-time Delphi survey, which was emailed to members of the expert panel. Members were asked to rank 70 statements across nine domains using a 9-point Likert scale. Consensus criteria were defined a priori and guided by previous research using 9-point rating scales.

Results Fifty members responded to the survey representing an overall response rate of 58%. Following analyses of the survey responses, the research team reviewed statements for content overlap and refined a final list of statements across the following domains: aims and objectives of the FFD model of care, target population, screening and assessment, interventions, technology, integration of care, evaluation and metrics and research.

Conclusion Development of a consensus-derived FFD model of care represents an important step in generating national standards, implementation of a service model as intended and enhances opportunities for scientific impact. Future research should focus on the development of a core outcome set for studies involving older adults in the ED.

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