Abstract

Complex services working under pressure are a fertile source of myths and misconceptions that can hinder a constructive search for creative solutions. A paucity of robust information inevitably reinforces such a collective mindset. We describe a systematic prospective survey of acute medical admissions using locally relevant definitions and direct clinical assessment of frail and/or elderly patients. This generated a large credible information set which had the confidence and support of staff across a range of professions and departments, thus sweeping aside several prevailing misunderstandings and paving the way for realistic planning and change management.