The Iowa Geriatric Education Center (IGEC) is working to improve frailty detection and management to optimize health outcomes. A curriculum is in development to educate health care providers on the timely recognition of the frail patient in all levels of patient care. The most common setting for complications of frailty is the acute hospital setting, which also permits an opportunity to teach families regarding the implications at that point of care.

IGEC faculty designed a frailty calculator which has been piloted within the Epic electronic health record system (EHR) at the University of Iowa Hospitals and Clinics (UIHC). The frailty calculator prompts the user when the criteria for frailty are met and populates the electronic record with the frailty score. This calculator has demonstrated the capability to educate providers as well as deliver meaningful data captured in the system. A Patient and Family Frailty Education Sheet is produced by the EHR system when a frail patient leaves the acute setting, with a special highlight to call attention to the individual factors that triggered the positive screen. For example, a patient who triggered a positive score by weight loss would be provided materials on nutrition. The goal is to disseminate this tool to other health systems that use the Epic EHR, but the frailty calculator can also be paper-based for those not using Epic.

IGEC faculty is dedicated to sharing frailty education as widely as possible. The outpatient setting provides the opportunity to detect an insidious progression of frailty at the earliest possible juncture when intervention may have its greatest impact. For this reason, the curriculum provides intervention strategies that target the primary care outpatient setting. These interventions are inherently interdisciplinary and involve patient engagement such that tailored teaching can enhance health outcomes and patient quality of life. The curriculum will be available in Epic-linked online learning tools to allow point of care learning that is relevant to the patient case at hand. The online curriculum will also be offered to the community-based residencies across the state via lectures provided by our geriatricians.

In addition, the awareness of frailty is readily teachable to the lay community as it involves common symptoms that patients can self-assess. The FRAIL Screening Tool consists of five simple questions that address key concepts. This screening tool will be linked to an intervention toolkit that provides health strategies and motivational lessons for the older adult and their family to implement physical activity, better illness management, and nutritional interventions. Since these strategies respond to group encouragement and engagement, simple web-based social support groups are in the process of development for frail and pre-frail individuals.