The Edmonton Frail Scale

Screenshot from the website showing two older couples dancing, with the title The Edmonton Frail Scale; the subtitle Assessing Frailty, quick, efficient, multidimensional; and the buttons reading COVID-19 frailty measures and resources, and Start using the EFS

Developing a Complete Training System

The Edmonton Frail Scale (EFS) is a multidimensional frailty measure that can be used for case-finding, to estimate severity, and to enhance care planning. We worked with Dr. Darryl Rolfson, the creator of the EFS, to develop a complete training and certification system.

Frailty is a complex, multidimensional concept that commonly carries a negative stigma. In the past, health professionals have had difficulty understanding frailty, perhaps because it doesn't’t fit their paradigm for medical problems. But an improved understanding of frailty should lead to better decisions about patient care.

Dr. Darryl Rolfson developed The Edmonton Frail Scale at the University of Alberta in 1999. It is a tool that provides a single score of a patient's overall frailty status, as well as identifies specific aspects of frailty that require follow up.

The Challenge

Edmonton Frail Scale began as a paper form. As it began to become more widely used, there was a need to distribute the scale and provide appropriate training on how to properly administer the scale to relevant healthcare providers, researchers, patients, and family members. But just like frailty itself, assessing frailty is complex. The development of a training system needed to support the subtle, complex, and multidimensional nature of frailty, and of the Edmonton Frail Scale.

"Frailty involves a dynamic interaction between individual capacity, external resources, and stress."

What We Did

Paper Form Redesign

Our design team worked with Dr. Rolfson to define and articulate his goals for The Edmonton Frail Scale. One of these goals was to make the tool more accessible through design. We worked with Dr. Rolfson on a re-design of the scale to create a final form that is intuitive, easy to use, and that will ultimately enforce the best practices for assessing frailty that The Edmonton Frail Scale stands for.

EFS form design
Redesign of the Paper Form.
EFS care team illustration
Custom Illustrations Created for the EFS.

Training Video Development

As part of our implementation effort, we developed a training video with Dr. Rolfson on how to appropriately and administer the scale. This video aimed to guide healthcare providers and researchers on how to properly use the scale in their practice.

Behind the scenes of the EFS video shoot, an older woman is seen from behind talking with a man

Behind the scenes of the EFS video shoot, a man holds rolled up papers, a woman works on a couch, and a man looks at papers beside a tripod

Behind the scenes of the EFS video shoot, a woman works on a couch, a man watches from behind lights, and a man reads from papers beside a tripod

EFS video preview
EFS Training Video.

Website Developement

We developed a website as a platform to house and distribute The Edmonton Frail Scale training system. This was a place to provide each audience with relevant information on frailty and The Edmonton Frail Scale, as well as connect them to the training resources.

What We Learned

Piloting of the training resources helped identify a need for a training curriculum along with the training materials. We set out to create a training course based on the existing training materials that would include a way for trainees to demonstrate competency upon completion of the course.

EFS course preview, showing Lesson 3 of 17 (EFS Section 1: Cognition). There is a video, and below that the introductory content for Clock Drawing Test, Getting Started. Along the left is a navigation bar with the other modules.
The Edmonton Frail Scale Training Course.

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