Frailty
Conditions
Keywords
Frailty, Geriatric assessment, Emergency service, Feasibility studies, Geriatric emergency medicine
Brief summary
The purpose of this study is to evaluate the feasibility and acceptability of the Clinical Frailty Scale (CFS). The scale can potentially be adopted for daily use in the Emergency Department (ED) and have been evaluated with regard to feasibility to a certain extent, but have so far not been evaluated in the Swedish emergency care context.
Detailed description
The CFS is introduced and tested as part of a quality-improvement process regarding elderly people within the three Emergency departments (ED) of Region Östergötland. CFS is a 9-point scale developed within the Canadian Study of Health and Aging, a pictograph and a clinical description aids to assign scores from very fit to terminally ill. The scale enable clinicians to stratify elderly people's degree of frailty with the help of questions and clinical assessment. However, even excellent tools will not be used if they are too difficult or time consuming. The amount of papers addressing issues regarding feasibility and acceptability of the CFS in a clinical ED-setting is still limited, and for Swedish EDs non-existent. This study is part of a larger research project, data will be collected in three ways: A. All eligible patients who visit the ED for a period of six weeks will be enrolled, and subsequently assessed with CFS by one of their responsible health-care professionals (i.e. physician, registered nurse or nurse assistant). The number of screened patients divided by the total number of eligible patients will yield the screening rate. Patient- and organisational related characteristics will be collected from the electronic health record. B. 100 patients will be assessed when someone from the research team is present to enrol patients and clock the assessments. These work shifts will be selected using the online application Research Randomizer, to randomly include all hours of the day as well as eligible health-care professionals. The research-team member will document the time to complete the assessment using CFS, which will give us the screening time. C. To assess acceptability, health-care professionals will be sent a questionnaire per email, including two reminders. The questionnaire will consist of Likert scales, multiple-choice questions and open textboxes with the aim to explore facilitators and barriers for screening completion. Primary aim: To explore the feasibility and acceptability of the CFS in a Swedish Emergency care context.
Interventions
None listed
Sponsors
University Hospital, Linkoeping
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Has been in clinical work at the ED for the period of the current study
Exclusion criteria
* Unwilling to provide informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Completion rate | During a period of six weeks | Proportion of completed Clinical Frailty Scale assessments in relation to the number of eligible patients |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient related characteristics correlated to completion rate | From admission to discharge from the Emergency department, up to 24 hours. | Age, gender, arrival mode, triage priority and discharge destination compared between the screened and not screened patients |
| Organisational related characteristics correlated to completion rate | From admission to discharge from the Emergency department, up to 24 hours | Day and time of arrival compared between the screened and not screened patients |
| Ease of use | Questionnaire that can be answered within five weeks | The proportion of distributed answers to alternatives 1 (Not at all easy) to 7 (Very easy) to the question: What is your experience of how it is to decide what CFS score a person has ? |
| Duration of time to make the assessment | The assessment will be made in connection with the patient´s first meeting with the care team, i.e. within 1 hour from the patient´s arrival to the ED | Measured time from that the health care professionals begins to read the instructions until he/she notes the assigned score. |
| Facilitators to perform assessment | Questionnaire that can be answered within five weeks | Health care professionals descriptions of what facititates performance of frailty assessments, qualitative analysis of the respondents' written answers in a free text box |
| Barriers to perform | Questionnaire that can be answered within five weeks | The proportion of distributed answers to existing alternatives, and qualitative analysis of the respondents' written answers in the free text box other reason. |
| Relevance | Questionnaire that can be answered within five weeks | The proportion of distributed answers to alternatives 1 (Completely irrelevant) to 7 (Very relevant) to the question: How relevant or irrelevant do you experience that it is to use CFS in the emergency department? |
Countries
Sweden
Outcome results
None listed