Rising star doctor shines in Swansea Bay

A Swansea Bay doctor has been described as ‘a rising star’ for her work in helping improve the care of elderly patients.

Dr Alexandra Burgess, a specialist registrar in geriatric and general internal medicine at Morriston Hospital, recently became the first Welsh winner of the British Geriatrics Society’s Rising Star Award for Clinical Quality.

Pictured above: From left to right, Alexandra with OPAS team members Kallum Matthews, Patrica Quinn and Danielle Treseder.

The prestigious award recognises doctors, nurses and allied health professionals who have already made exceptional contributions to the field of older people's healthcare.

The award is aimed at staff early in their careers (within 15 years of qualification) who have been recognised as being potential leaders within healthcare for older people.

As well as being a member of the hospital’s OPAS (Older Persons Assessment Service) team, Dr Burgess is a Doctor of Medicine (MD) student at Swansea University.

She impressed the judges through her work in designing and delivering innovative new models of care while providing substantial input into developing pre-hospital frailty rapid response services at Morriston Hospital.

Dr Burgess, who has developed an electronic frailty flagging system in the hospital’s emergency department, explained why she chose geriatrics as her specialist field. 

She said: “I find as people get older, they are more of a puzzle. I think with geriatrics you're a bit of a detective trying to work out the reason why somebody has suddenly deteriorated.

“You work as a part of a wider team with nurses, advanced clinical practitioners, clinical nurse specialists, physician associates, occupational therapists and physiotherapists and together as a team, you try to work out why someone's had a deterioration.

“It's a team working with general medicine.”

One area she is keen to address is the amount of time older people spend in an ambulance waiting to be admitted..

She said: “We found that the older you are the more likely you are to have an increased delay outside Morrison Hospital in an ambulance. You're at increased risk of pressure damage. 

“We also found that the longer you wait, the more likely you are to stay in hospital for longer and you have an increased mortality risk.

“So we're working with the ambulance service to find ways of reducing these offload delays for our older patients.”

Dr Burgess’s studies tie in with her work at the hospital.

She said: “I've done a lot of research trying to develop a frailty-specific same day emergency care score, based on Swansea Bay data. 

“I'm currently validating that retrospectively, so looking to see whether my score would have worked at predicting admissions.

“I think that'll be the bulk of my thesis for my MD, focusing on how to improve access to ambulatory care for older adults who aren't picked up in the standard scores.”

There are several systems in place around the world but Dr Burgess wants to create one more specific to the UK.

She said: “Basically, they're all scores which are used internationally to try and help clinicians decide whether somebody can stay in or whether they can be managed via our ambulatory care pathways, of which we're trying to develop a lot more of in Swansea Bay.

“And that's also a focus of the Royal College of Physicians of the British Geriatric Society and the Welsh Government.

“It's all about trying to improve access to ambulatory care and to provide appropriate care at home.”

Dr Burgess said the key was ensuring hospital stays, for the benefit of the patient, were as short as possible.

She added: “We know that the Emergency Department (ED) and AMU (Acute Medical Unit) are not the right environments for our older, frailer adults.

“We know, as health practitioners, lots of the things we do in people's best interests such as using catheters, cannulas and cardiac monitors are tethering devices which can make delirium worse.

“If we can see these people at the front door, whether that's via ED or AMU, we can hopefully put things in place to help support patients returning home so that they don't need to stay in hospital. We don't have the deconditioning, we don't have the delirium.”

Dr Burgess said winning the prestigious award had validated the work she and her colleagues were undertaking in Morriston Hospital.

She said: “I'm the first person to win it from Wales, which is a huge bonus. I couldn't believe that. I'm absolutely in shock. 

“This award has validated the work we're doing as not only worthwhile locally, it could really change the face of geriatric medicine, not just in Wales but across the UK.”

Dr Elizabeth Davies, a consultant geriatrician, added: “Alex has conducted a significant amount of work reviewing our systems in acute frailty, alongside and as part of her ongoing research as an MD student. 

“She has been a great asset to the department. She has helped to design, implement and deliver a number of projects with a particular emphasis on prehospital intervention. 

“She has achieved a tremendous amount in a short time. 

“We are extremely proud of her. I have no doubt of her future success and contribution to the field and that she will make an excellent consultant colleague when the time comes. 

“Well done Alex on another very well deserved success.”

Dr Burgess will present her work to the British Geriatric Society’s conference in London in November.