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Abstract

Crawfurd Hospital (CFH) set up a Transitional Care Facility (TCF) in November 2022 as an interim holding facility for medically stable patients awaiting a long-term discharge disposition. The team invented the SAFE score, to monitor 4 main domains commonly impacted in long-term stays – namely Skin, Action (Behaviour), Function and Emotion. A sample size of 50 patients met the inclusion criteria and were scored by the nurses on day 7, day 14, and monthly thereafter during their TCF stay, and once more within 72 hours prior to their discharge. There was no significant improvement or worsening noted across all 4 domains in this pilot study, suggesting that the TCF has achieved its goal of maintaining its patients in all these domains. The scores at the various time points were also useful for the team to immediately identify changes in individual patient scores and act on these findings to ensure optimal patient care. Through this pilot study, we identified further minor improvements which can be made to the and the score, and such a scoring system may further be applicable to various intermediate to long-term care homes to oversee these domains of care.

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