Reducing the impact of hospital stays

Older people are at greater harm from a combination of serious illness and the hospital environment, leading to geriatric syndromes such as delirium, functional decline, falls, incontinence and pressure injuries.

Developed by Adjunct Professor Alison Mudge, Ms Prue McRae and multidisciplinary colleagues at Royal Brisbane and Women’s Hospital, the Eat Walk Engage program is a systematic approach to address these challenges and reduce decline in older patients in medical and surgical wards.

Adj Prof Mudge says watching older patients and relatives struggling with their increasing frailty and the indignities of the hospital system inspired her work.

“The interviews we undertake with older patients on each new ward help me to step outside my professional role, and really highlight how important the small things – a kind word, a hot cup of tea, a seat in the sun – are to the recovery process,” she says.

“Older people should be confident that hospitals are places where they get good evidence-based care, do not suffer unnecessary harm, and are treated with respect and kindness.

“Eat Walk Engage supports our healthcare teams to get the evidence into practice, reduce serious complications, and get older patients back to their usual function sooner.”

Eat Walk Engage is being tested at scale in four hospitals in the Collaborative for Hospitalised Elders: Reducing the Impact of Stays in Hospital (CHERISH), a
two-year project funded by a $1.5 million Queensland Accelerate Partnership Grant, with contributions from Queensland University of Technology, the Australian Centre for Health Services Innovation, Metro North and Sunshine Coast Hospital and Health Services, and the Queensland Government.

The project has employed four facilitators, four data collectors, and four allied health assistants in Metro North and Sunshine Coast Hospital and Health Services, as well as a project manager and data manager.

To be completed this year, the study is collecting data on over 1000 older patients admitted to wards at Caboolture, The Prince Charles, Royal Brisbane and Women’s and Nambour Hospitals, and will compare outcomes on four wards implementing Eat Walk Engage and four control wards.

Adj Prof Mudge says the issue is fast becoming more pressing as the average Australian life expectancy increases. Fortunately, the research team is already seeing results.

“We know that there’s an increasing demand driven by the aging population,” she says.

“We have seen very promising changes on the wards that we have been working with as part of the CHERISH project, and seeing real improvements in the way that staff think about and care for their older patients.”