Darryl Rolfson MD, FRCPC, graduated in medicine at the University of Alberta in 1993 and completed residencies in Internal Medicine in 1996 and Geriatric Medicine in 1998. Dr. Rolfson is currently a Professor with the Department of Medicine at the University of Alberta. His clinical practice is in Geriatric Medicine. His research interests are in Frailty in the Elderly and Medical Education. From 2008 to 2017, Dr. Rolfson was the residency program director for Internal Medicine at the University of Alberta.
Implementation of the Edmonton Frail Scale in Home Care
Frailty is common in community care settings, but rarely assessed and used to inform a care and support plan. The Edmonton Frail Scale (EFS) is a multidimensional frailty measure, and its use in a home care setting allows case finding, estimation of severity, and definition of frailty components. In 2017, the EFS was selected for use by Edmonton Zone Home Care. We followed a process of implementation, starting with copyright and licensing. Systems Case Managers (SCMs) formed a focus group to inform the development of a draft training manual. Subsequently, proof of concept work was conducted with three SCMs in clients seen in home care settings.
Based on this, the format of the EFS and training manual were redesigned with the guidance of the office of Academic Technologies, University of Alberta. A website and training video were also developed. Finally, an online training program was developed which included brief vignettes and formative and summative self-testing. The EFS will be further implemented in beyond SCMs to all members of the home care team.
The EFS is central to a clinical knowledge topic on Frailty in Acute Care released for use throughout Alberta in May 2018. This knowledge topic includes an order set that aligns with each of the EFS components. Our training materials will be made available to inform its use in acute care. Likewise, we intend to develop care guidelines derived from the EFS and its components that can be employed in ambulatory settings.