Article Text
Abstract
Introduction Directing care goals according to the individual values of our patients is a key element of Institute for Health Improvement Age-Friendly hospital systems. The intention is to shift our focus to addressing issues that matter most to each individual. Patients assessed by an Emergency Department (ED) based Frailty Intervention Team (FIT) are routinely asked ‘What Matters To You’ (WMTY).
Methods A thematic analysis of WMTY over a 12 month period from 1st January to 31st December 2022 was performed.
Data was routinely collected from Comprehensive Geriatric Assessments, and entered prospectively onto Excel by a trained administrator. Age, Gender, Clinical Frailty Score (CFS) and documentation of ‘WMTY’ was analysed. Patient responses for WMTY was separated into themes by a Clinical Nurse Manager for the Older Person, and validated by a Consultant Geriatrician.
Results 592 patient responses were analysed. Mean (SD) age was 83 (6.9) years. Female:male ratio was 1.5:1. Mean (SD) CFS was 5 (1.2).
468 (79%) patients had documentation of WMTY. Ninety patients expressed 2 different WMTY. Five themes emerged – 1. Home (n=191; 41%), 2. Health and independence (n=173; 37%), 3. Family and pets (n=133; 28%), 4. Personal concerns i.e. religion, company, personal safety, career, death, finances (n=28; 6%), and 5. Hobbies (n=21; 4.5%).
Conclusion Recorded WMTY in this frail older population centred around home, family, health and independence. The question was either not asked or answered in a significant minority. Personal concerns revealed important individual concerns that occasionally merited specific attention.
As familiarity grows with WMTY within patient populations, and within teams who ask that question, more meaningful answers should emerge. This should help direct compassionate care for this group of patients. Next steps are to support the team in further teasing out WMTY, and incorporating into patient care in the wider ED.