Pilot implementation of the mod-REFS frailty screening tool in an Australian home care provider to improve client health and well-being

  • 1Bolton Clarke Research Institute, Melbourne, Victoria, Australia.
  • 2Bolton Clarke, Melbourne, Victoria, Australia.
  • 3School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Abstract

OBJECTIVE

Frailty refers to increased vulnerability and decreased resilience with associated increased risk of adverse health outcomes. Frailty mostly affects older adults; hence, early identification is necessary to prevent further decline. To help optimise health and well-being, we aimed to implement a holistic frailty screening tool, the modified Reported Edmonton Frail Scale (mod-REFS) within an Australian aged and community home care provider.

METHODS

The Implementation Framework for Aged Care guided implementation and evaluation, including co-design with key stakeholders. Clinical (nurses and allied health) and non-clinical (personal care workers) home care staff administered the mod-REFS in a pilot. Evaluation of feasibility, acceptability and fidelity of the tool was undertaken using administrative data alongside a staff survey.

RESULTS

Between July and October 2023, the mod-REFS was completed for 218 clients from Queensland and Victoria, with almost two-thirds (n = 142, 65%) identified as either prefrail (n = 57, 26%) or frail (n = 85, 39%). A greater percentage were prefrail and frail in Victoria than in Queensland. The staff survey (n = 27) identified that the mod-REFS was considered helpful by most (n = 15, 55%); quick, easy to use, concise, very practical; and able to identify frailty levels and other important issues such as depression. Most staff (n = 23, 85%) required no training to use the tool.

CONCLUSIONS

Implementing the mod-REFS to identify prefrailty or frailty was feasible and acceptable when administered by a range of home care staff. Implementation requires input from all stakeholders. Early identification and intervention could prevent deterioration and improve well-being of those receiving home care services.