The IMPACTFrail program is an intrinsic capacity (IC) identification and management program for mildly frail older adults. Specifically, it delivers the three-tier approach recommended in the National Frailty Strategy Policy Report. The program's core functions include the segmentation of older persons using the Clinical Frailty Scale (CFS) score followed by secondary IC screening for CFS 4 to 5 (Tier 1), follow-up clinical assessment to confirm IC losses (Tier 2) and needs-directed management and tracking of their health (Tier 3).
The investigator aims to conduct a multi-site feasibility study on a small group of older adult study participants (n=30 per polyclinic).
The feasibility study has a few components. First, a qualitative study will assess its feasibility (implementation, appropriateness, acceptability, practicality, adaptability) as perceived by older adults, healthcare providers, and healthcare administrators. Second, the investigator aims to collect process indicators to track its implementation progress. Third, program costs will be estimated. Fourth, the investigator will develop a logic model and theory of change, and cluster-specific detailed written program descriptions. Lastly, the investigator aims to triangulate the findings and assess the feasibility for larger-scale implementation. This study is guided by implementation science frameworks and guidelines for conducting feasibility studies.
being a patient of the polyclinic site
aged 60 years and above
Clinical frailty score (CFS) of 4 - 5
Not done comprehensive geriatric assessment (CGA) in the past 12 months (based on available medical records or self-report)
Do not meet inclusion criteria above
aged 21 years and above
Involved in the IMPACTFrail program as an implementer and/or a healthcare administrator with authority to make implementation decisions.
Do not meet inclusion criteria above
Older adults will be polyclinic patients aged 60 years and above with CFS score 4 or 5 as assigned by a trained healthcare provider at the polyclinic. They should not have done any comprehensive geriatric assessment or be currently receiving geriatric specialist outpatient services. Healthcare staff can be polyclinic healthcare providers (e.g., polyclinic doctors, nurses, care coordinators, care managers, medical social workers). Healthcare administrators would be from the polyclinic leadership team, who are decision-makers who have the authority to make implementation decisions and are familiar with the overall frailty and IC management strategies in primary care in Singapore.
Other
Prospective
The IMPACTFrail programme
Other interventionThe IMPACTFrail programme
Qualitative study 1
What will be measured: Deviations to the intended execution of the programme and implementation strategies and reasons for changes made. How will it be measured: Via in-depth interviews (IDIs) and focus group discussions (FGDs) with healthcare administrators and healthcare providers. All participants for the qualitative study will be identified through purposive sampling. We will adopt the Rapid Qualitative Inquiry (RQI) approach in data analysis.
Qualitative study 2
What will be measured: Barriers/facilitators of implementing/receiving the programme and its implementation strategies. How will it be measured: Via in-depth interviews (IDIs) and focus group discussions (FGDs) with healthcare administrators, healthcare providers, and older adults. All participants for the qualitative study will be identified through purposive sampling. We will adopt the Rapid Qualitative Inquiry (RQI) approach in data analysis.
Qualitative study 3
What will be measured: Perspectives on the ability to deliver innovation with given resources (manpower, infrastructure, IT, others). How will it be measured: Via in-depth interviews (IDIs) and focus group discussions (FGDs) with healthcare administrators and healthcare providers. All participants for the qualitative study will be identified through purposive sampling. We will adopt the Rapid Qualitative Inquiry (RQI) approach in data analysis.
Qualitative study 4
What will be measured: Suggestions on how to improve the implementation of the programme for scalability and sustainability. How will it be measured: Via in-depth interviews (IDIs) and focus group discussions (FGDs) with healthcare administrators and healthcare providers. All participants for the qualitative study will be identified through purposive sampling. We will adopt the Rapid Qualitative Inquiry (RQI) approach in data analysis.
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Geriatric Education and Research Institute
Lead sponsor
National Healthcare Group Polyclinics
Collaborator
National University Polyclinics
Collaborator
SingHealth Polyclinics
Collaborator
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