Province-Wide Implementation of the Clinical Frailty Scale in a Electronic Medical Record System (eCritical) in Alberta

Integration of the Clinical Frailty Scale (CFS) will add value to the care of frail patients admitted to intensive care units (ICUs) by enabling the identification of those who are most vulnerable and at-risk for poor outcome, by introducing mechanisms to measure the quality of care received by frail patients, by translating these data during transitions of care and across a spectrum of providers, and by creating a platform to design, evaluate and implement innovative strategies, care pathways or interventions targeting frailty.

Research Results

Project findings and information will be updated on a continual basis.

About the Project

An episode of critical illness may be a sentinel event for a vulnerable patient to transition to a frail state and may also be an unrecognized factor impeding the recovery and functional autonomy in those already frail. There has been limited evaluation of frailty among patients admitted to ICUs.

After completing a prospective multi-center study evaluating frailty among adult patients admitted to ICUs across Alberta, we found frailty was exceedingly common, evident in 33%, while a further 32% were characterized as “vulnerable”. Frail patients suffered a higher risk of adverse events, longer stays in ICU and hospital, higher mortality, and among survivors, greater incident disability and impaired quality of life. Importantly, we showed that frailty can be measured in a heterogeneous mix of ICU patients at the point of care.

For the next phase of our work, we will implement a simple validated tool, the CFS score used in our initial work, as part of the routine admission data. We will first broadly engage inter-disciplinary stakeholders to educate them about frailty and learn how best to implement the CFS score, leveraged through our provincial Critical Care Strategic Clinical Network.

Project Team

Principal Investigators:

Sean Bagshaw, MD, MSc, FRCPC — University of Alberta

Darryl Rolfson, MD — University of Alberta

Henry Stelfox, BMSc, MD, PhD — University of Calgary

Dan Zuege, MD, MSc, FRCPC — University of Calgary

David Zygun, MD, FRCPC — University of Alberta

Co-Investigator:

Darren Hudson, MD — University of Alberta

Knowledge Users and Partners:

Olajide Olabode, BScPT, MPH — Division of Critical Care Medicine, University of Alberta

Alberta Critical Care Strategic Clinical Network

eCritical Alberta

iMDsoft

Project Contact: Sean Bagshaw — bagshaw@ualberta.ca

FRA 2015-B-20