- Awards and Honours
- 2 min read
Monash Health has received the Outstanding Overall Improvement award for its innovative approach to timely care for frail, elderly patients, reducing hospital stays and admission rates through early identification and specialist intervention.
Monash Health has been recognised with an Outstanding Overall Improvement award for its innovative work delivering timely care to older patients, cutting inpatient length of stay by 21 hours and decreasing admission rates by 6%.
This outstanding result is driven by a front-door frailty model of care that launched at Monash Medical Centre, Clayton, in 2025. The model ensures that frail, elderly patients presenting to the Emergency Department are quickly identified and assessed by Monash Health’s Acute Frailty Team. The team assesses the patient’s need for emergency care or admission into hospital, finding community and non-hospital-based alternatives whenever possible for this vulnerable cohort.
Reducing risks through early identification
‘We’re identifying patients who are frail very early in their journey, knowing that they are the most vulnerable, and getting a plan for them to either get home immediately or reduce the amount of time that they spend in hospital,’ said Alisha Spiteri, Geriatrician at Monash Health’s Emergency Department and Medical Lead for the Monash at Home ARC service.
A key focus of the project is to reduce clinical risks for frail patients, understanding that every day spent in hospital increases the patient’s risk for deconditioning, including physical and functional decline, muscle loss, pressure injuries, falls, infections, reduced ability to perform daily activities, delirium and worsening confusion and dementia.
‘It’s very clear that if we can get frail people seen quickly and reviewed by our specialist team, we can often avoid an admission,’ said Kerry Georgiou, Acting Nurse Manager, Adult Emergency Department.
‘If we can avoid that, we avoid deconditioning, and for those that do need an admission, we reduce their overall length of stay.’
Enduring positive results
The Monash Health team received the Outstanding Overall Improvement award at the Department of Health’s Timely Emergency Care Two (TEC2) awards ceremony held last month. The award recognises the team’s longstanding improvement in inpatient length of stay, which has endured for over a year and resulted in the team exceeding its goal, reducing length of stay by 21 hours compared to baseline.
Between July and October 2025, the team identified 185 frail patients across our Clayton and Dandenong sites, of whom they were able to divert 94 patients from admission to appropriate care at home. In November and December 2025, the number of frail patients identified and seen increased to 270 and 164, respectively, resulting in an outstanding total of 258 patients receiving care at home rather than requiring admission.
Aside from these impressive numbers, the award recognises the grit, determination and strategic smarts in the face of significant adversity that the team has demonstrated throughout this journey, as well as their generosity in sharing knowledge with their peers and true system leadership.
Congratulations to the teams at Monash Health, particularly our Emergency Department and Acute Frailty Team, for this outstanding achievement.
