Introduction
Frailty is defined as a collective of social and medical conditions which lessen a patient’s reserve over time, increasing vulnerability to a variety of stressors. Frailty has been recognized as an independent risk factor in several sub-optimal surgical outcomes.
The Frailty Resources Toolkit has been developed to assist MSQC sites in caring for patients identified as frail using either a validated screening tool or clinical judgement. This content has been collected with the purpose of assisting sites participating in the Frailty Quality Improvement project, however these principles can be applied to at risk or frail patients across the collaborative.
Toolkit Components
Tools: a collection of validated screening tools along with plans aimed at offering evidence-based methods of improving care to this population. These tools may be used in future quality improvement work as opportunities for improving the care of this vulnerable population are identified.
Articles: a collection of peer-reviewed journal articles outlining the current work being done to optimize care for this population. This list will be periodically updated to reflect current findings and best practices identified in this area.
Tools
- Guidelines for risk discussion with Frail identified patients
- Preoperative management of frail patients from the American College of Surgeons Geriatric Surgery Validation Program
- Intraoperative management of frail patients from the American College of Surgeons Geriatric Surgery Validation Program
- Postoperative management of frail patients from the American College of Surgeons Geriatric Surgery Validation Program
- General tips and tools for managing frail patients
- BEERS list of high risk medications for geriatric patients
- EPIC programming guide for RAI Scale
Articles
- Perioperative frailty: lessons learned and future directions
- American Geriatrics Society Abstracted Clinical Practice Guideline for Postoperative Delirium in Older Adults
- American Geriatrics Society Clinical Practice Guideline for Postoperative Delirium in Older Adults
- Recommendations for Preoperative Management of Frailty from the Society for Perioperative Assessment and Quality Improvement (SPAQI)
- Peri-operative optimization of elderly and frail patients: a narrative review
- Frailty in the perioperative setting
- The Effect of a Frailty Management Program on the Rehabilitation of Elderly Patients after Surgical Treatment
- Preoperative frailty assessment combined with prehabilitation and nutrition strategies: Emerging concepts and clinical outcomes
- Delirium Guideline Evidence Tables
- Interventions to improve the outcomes of frail people having surgery: A systematic review
- Frailty for Perioperative Clinicians: A Narrative Review
- Prehabilitation for the Frailty Syndrome: Improving Outcomes for Our Most Vulnerable Patients
- Preoperative risk analysis index for frailty predicts short-term outcomes after hepatopancreatobiliary surgery
- Frailty Screening and Interventions Co