A Partnered Evaluation to Improve the Identification and Management of Functional Impairment and Frailty Among Older Veterans in Primary Care Settings

Summary

Maintaining functional status, or the ability to perform daily activities, is central to older adults' quality of life, health, and ability to remain independent. Identifying functional impairments is essential for clinicians to provide optimal care to older adults, and on a population level, understanding function can help anticipate service needs. Yet uptake of standardized measurement of functional status into patient care has been slow and inconsistent due to the burden posed by current tools. The purpose of the proposed QUERI Partnered Evaluation Initiative is to implement and evaluate a patient-centered, low-burden intervention to improve measurement of functional status in VA primary care settings nationally. The investigators hypothesize that implementing this intervention will increase identification and improve management of functional impairment among older Veterans while providing key data to inform VHA strategic planning related to long-term services and supports.

Conditions

• Functional Impairment
• Frailty

Interventions

OTHER

Screening intervention

Intervention to improve identification and management of functional impairment among older Veterans in VA primary care settings. Intervention includes 5 components: (1) routine, standardized functional status measurement; (2) nursing screening followed by follow-up primary care provider assessment; (3) electronic tools and templates to facilitate screening, assessment, and documentation; (4) interprofessional educational session; (5) tailored reports on functional status

OTHER

Standard bundle of implementation strategies

Standard strategies include champions plus system-level audit and feedback

OTHER

Enhanced bundle of implementation strategies

Enhanced strategies include technical assistance plus clinician-level audit and feedback

Sponsors & Collaborators

• VA Office of Research and Development

  lead FED

Principal Investigators

• Rebecca T. Brown, MD MPH · Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA

• Francesca M Nicosia, PhD MA · San Francisco VA Medical Center, San Francisco, CA

Study Design

Allocation

RANDOMIZED

Purpose

SCREENING

Masking

NONE

Model

CROSSOVER

Eligibility

Min Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-04-01

Primary Completion

2026-06-30

Completion

2026-12-31

Countries

• United States

Study Locations