Occupational therapy in urgent care
18 March, 2025
The right care, in the right place, at the right time
A weekend trial was conducted to implement an integrated therapy team in the emergency department of a large acute teaching NHS trust, aimed at facilitating admission avoidance for older adults.
One in five people attending urgent care facilities are over the age of 65, and many do not need to be admitted to hospital. The growing demand from older adults results in frequent hospital visits, and many of these patients occupy beds that could be used for other patients.
Completing a comprehensive geriatric assessment (CGA) is considered the gold standard for caring for frail older people and has been shown to improve health outcomes, independence and reduce the need for long-term care.
Occupational and physiotherapy teams play a key role in the CGA process, particularly in conducting functional and social assessments. Research has demonstrated that these therapies can prevent unnecessary admissions and facilitate timely discharges from the emergency department.
A new approach
At the trust, the emergency department was supported by two teams: a frailty team and an admission avoidance team, both providing services during weekdays. However, there was a noticeable gap in support for admission avoidance during weekends. To address this, a project was initiated to extend therapy services into the emergency department on weekends.
Funding was secured for an additional Band 6 therapist to support with the weekend trail, and physiotherapists and occupational therapists worked together to deliver assessments for frail older patients.
The impact
The trial lasted for three months and used data collection sheets to track referrals, response times and patient demographics. The team received 23 referrals over the trial period. Of those assessed, 52% were discharged home, while others were admitted for ongoing therapy or medical needs.
The trial demonstrated that having therapists present in the emergency department on weekends significantly improved patient outcomes and reduced unnecessary hospital admissions.
The data collected reinforced the need for a seven-day therapy service within the emergency department, highlighting the essential role of occupational and physiotherapy in supporting frail older patients.
Following the trial, the older persons therapy team has continued to provide weekend support, showcasing the positive impact of specialist therapy services on patient care.
Key takeaways
- Integrated therapy teams enhance urgent care – implementing occupational and physiotherapy services in emergency departments improves care for older adults.
- Comprehensive geriatric assessments are critical – early CGAs help improve health outcomes and reduce unnecessary hospital admissions for frail patients.
- Weekend therapy services are essential – providing support during weekends addresses service gaps and facilitates timely discharges.
- Collaboration with multidisciplinary teams is vital – effective communication and coordination improve patient flow and care transitions.
- Ongoing investment in therapy services is necessary – continued support for frailty specialists in emergency departments meets the needs of an ageing population.
This is a summary of an article first published in OTnews, in July 2024. Read it in full via OTnews. Reference: James K (2024) The right care, in the right place, at the right time, OTnews 32(7): 38-40
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