Authors List
Blanks V, Dunedin Public Hospital, Dunedin, New Zealand
Baxter N, Christchurch Public Hospital, Christchurch, New Zealand
Hyslop B, Dunedin Public Hospital, Dunedin, New Zealand
Nguyen MH, Dunedin Public Hospital, Dunedin, New Zealand

Introduction: Admitting older people into dedicated admission units improves outcomes.  In June 2019, an older person’s admission unit was opened at Dunedin Hospital named OPAL (Older Person’s Assessment and Liaison).  An 18-day feasibility trial showed that the OPAL model was feasible with suggestion of reduced length of stay (1). Operation of the unit was continued.

Aims: To determine the average length of stay, discharge destination and 30 day readmission rate for the first 100 admissions to the unit.

Methods: Relevant data was retrospectively collected from the electronic record for the first 100 patients admitted to OPAL. All readmissions were screened by the lead author to ascertain whether the admission was for the same issue as the index admission.

Results: Of the 100 admissions, 12% were admitted directly to OPAL, bypassing the emergency department (ED).  The primary reasons for admission included; fracture (15%), functional decline (68%), medical issue (16%) and pre-procedural care (1%). 47% of patients were discharged directly form OPAL, with an average length of stay of 3.6 days (range 1-13 days). 46/47 were able to return to their previous place of residence, with one patient discharged to a higher level of care. Of those discharged directly from OPAL, the 30-day readmission rate was 19%, 5/9 of which were for the same problem as the index admission.

Conclusions: The OPAL model is a feasible mode of admission for older patients. A significant proportion of patients are able to be directly admitted, bypassing ED. The average length of stay and readmission rate appear satisfactory. This analysis has no control group, so limited conclusions can be made, but OPAL appears to be achieving its goals of timely, efficient and comprehensive inpatient care for older people.
References
1) Baxter et al. Establishing an Older Person’s Admission Unit at Dunedin Hospital. ANZSGM NZ 2019.