Evaluating the Implementation and Feasibility of a Web-Based Tool to Support Timely Identification and Care for the Frail Population in Primary Healthcare Settings

Document Type: Study Protocol

Authors

1 Building Research for Integrated Primary Healthcare (BRIC NS), Nova Scotia Primary & Integrated Health Care Innovations Network, Halifax, NS, Canada

2 Primary Care Research Group, Dalhousie Family Medicine, Halifax, NS, Canada

3 Dalhousie University, Halifax, NS, Canada

4 Primary Health Care, Nova Scotia Health Authority, Halifax, NS, Canada

5 School of Occupational Therapy, Dalhousie University, Halifax, NS, Canada

6 Continuing Care, Nova Scotia Health Authority, Halifax, NS, Canada

7 Healthy Populations Institute, Halifax, NS, Canada

8 Palliative and Therapeutic Harmonization (PATH) Program, Halifax, NS, Canada

9 Department of Family Practice, Nova Scotia Health Authority, Halifax, NS, Canada

Abstract

Background
Understanding and addressing the needs of frail persons is an emerging health priority for Nova Scotia and internationally. Primary healthcare (PHC) providers regularly encounter frail persons in their daily clinical work. However, routine identification and measurement of frailty is not standard practice and, in general, there is a lack of awareness about how to identify and respond to frailty. A web-based tool called the Frailty Portal was developed to aid in identifying, screening, and providing care for frail patients in PHC settings. In this study, we will assess the implementation feasibility and impact of the Frailty Portal to: (1) support increased awareness of frailty among providers and patients, (2) identify the degree of frailty within individual patients, and (3) develop and deliver actions to respond to frailtyl in community PHC practice.
 
Methods
This study will be approached using a convergent mixed method design where quantitative and qualitative
data are collected concurrently, in this case, over a 9-month period, analyzed separately, and then merged to summarize, interpret and produce a more comprehensive understanding of the initiative’s feasibility and scalability. Methods will be informed by the ‘Implementing the Frailty Portal in Community Primary Care Practice’ logic model and questions will be guided by domains and constructs from an implementation science framework, the Consolidated Framework for Implementation Research (CFIR).
 
Discussion
The ‘Frailty Portal’ aims to improve access to, and coordination of, primary care services for persons experiencing frailty. It also aims to increase primary care providers’ ability to care for patients in the context of their frailty. Our goal is to help optimize care in the community by helping community providers gain the knowledge they may lack about frailty both in general and in their practice, support improved identification of frailty with the use of screening tools, offer evidence based severity-specific care goals and connect providers with local available community supports.

Keywords

Main Subjects


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