Virtual frailty screening: A quality improvement project to enhance community-based assessment

Background: Conventional approaches to frailty assessment rely on in-person evaluation by health professionals in medical settings. The COVID-19 pandemic drastically limited access to both primary care and face-to-face appointments, highlighting a need for novel and forward-thinking frailty screening methods to bridge this gap. Community-based seniors-serving organizations are well-positioned to implement remote frailty assessment, given its potential to enhance virtual services and referrals. Methods: The Clinical Frailty Scale (CFS) was adapted and implemented as Virtual Frailty Screening (VFS), using the Plan-Do-Study-Act (PDSA) framework, in an inner-city organization for older adults. Participants participated in phone assessments by social workers (SWs); in-person visits included the CFS for comparative purposes. As a component of our larger quality improvement initiative, pilot data were analyzed descriptively alongside inferential methods consisting of Kendall's τ_b, Χ²-test of association, and Wilcoxon matched-pairs signed-rank test. Results: Over 101 older adults were screened, with 79.21 % being assigned as very mild to moderately frail. VFS usage enabled crucial referrals for 70 older adults to receive long-term frailty-specific support and services in the community. Analysis found that the VFS performed similarly to the CFS, established by high convergent validity and alignment between both scales. Conclusions: Findings support the implementation of remote frailty assessment by SWs in community-based seniors serving organizations. This integration bridges immediate service gaps, introducing a transformative approach to frailty assessment which has the potential for scalability. Success was attributed to a multidisciplinary approach with rapid PDSA changes in a nimble organization.