Canadian Frailty Network (CFN): Transforming primary health care for older adults living with frailty

Based on findings from our previous research, we now plan to apply evidence-informed interventions to primary care locations across Alberta, Ontario, and Quebec in nine urban and rural sites.

Our research will address the following key areas:

  • Consistent risk screening and assessment;
  • Care coordination and system navigation;
  • Patient/caregiver engagement and shared decision-making; and
  • Enabling technology supports.

For more information on CFN, visit our partners page.

Implementation Guides:

Checklist (English)

Checklist (French)

Alberta Provider Implementation Guide

Ontario Provider Implementation Guide

Quebec Provider Implementation Guide

Sample Model Primary Care (English)

Sample Model Primary Care (French)

​​​​​​​Worksheet for Providers (English) ​​​​​​​

Worksheet for Providers (French)

Focus question

Compared to usual care in primary care settings, does our proposed model improve health, social and economic outcomes for older Canadians living with frailty?

Co-Principal Investigators

Paul Stolee, PhD: Professor, School of Public Health and Health Systems, University of Waterloo

Anik Giguère, PhD: Associate Professor, Department of family medicine and emergency medicine, Université Laval

Kenneth Rockwood, MD, FRCPC, FRCP: Professor, Faculty of Medicine,  Division of Geriatric Medicine, Dalhousie University

Joanie Sims-Gould, PhD, RSW: Assistant Professor, Faculty of Medicine, Department of Family Practice, University of British ColumbiaSample Model Primary Care (English)

Sara Mallinson, PhD: Seniors Research and Evaluation Consultant, Workforce Research and Evaluation, Alberta Health Services

Co-Investigators​

Veronique Boscart,RN, MScN, MEd, PhD: CIHR/Schlegel Industrial Research Chair for Colleges in Seniors Care, Conestoga College; Assistant Clinical Professor, School of Nursing, McMaster University

Andrew Costa, PhD: Assistant Professor, Department of Clinical Epidemiology and Biostatistics

Jacobi Elliott, PhD: Adjunct Assistant Professor, School of Public Health and Health Systems, University of Waterloo

Dorothy Forbes, PhD, RN: Professor, Faculty of Nursing, University of Alberta

Heather Hanson, PhD: Assistant Scientific Director, Seniors' Health Strategic Network, Alberta Health Services

Stephanie Hastings, PhD: Adjunct Assistant Professor, Department of Psychology, University of Calgary; Senior Research and Evaluation Consultant, Workforce Research and Evaluation, Alberta Health Services. 

George Heckman, MD, FRCPC, MSc: Associate Professor (Schlegel Research Chair in Geriatric Medicine), School of Public Health and Health Systems, University of Waterloo, Assistant Clinical Professor of Medici​ne, McMaster University

Jayna Holroyd-Leduc, MD, FRCPC: Associate Professor, Medicine and Community Health Science, University of Calgary

Ayse Kuspinar, PT, PhD: Assistant Professor, School of Rehabilitation Science, McMaster University

Samantha Meyer, PhD: Associate Professor, School of Public Health and Health Systems, University of Waterloo

Josephine McMurray, PhD: Assistant Professor, Business Technology and Management/Health Studies, Wilfrid Laurier University

Olga Theou, MSc, PhD: Assistant Professor, Department of Medicine, Dalhousie University

Holly Witteman, PhD: Assistant Professor, Department of Family & Emergency Medicine, Université Laval 

Mohammad Hajizadeh, PhD: Assistant Professor, School of Health Administration, Dalhousie University

Wanrudee Isaranuwatchai, PhD: Assistant Professor, Institute of Health Policy, Management, and Evaluation, University of Toronto

G. Ross Baker, PhD: Professor, Institute of Health Policy, Management, and Evaluation and Program Lead - Quality Improvement and Patient Safety, University of Toronto

Kerry Byrne, PhD: Adjunct Assistant Professor, School of Public Health and Health Systems, University of Waterloo

Catherine Burns, PhD: Professor, Systems Design Engineering, University of Waterloo

Kelly Grindrod, PhD: Assistant Professor, School of Pharmacy, University of Waterloo

Lucille Juneau, PhD: Researcher, Centre d'excellence sur le vieillissement de Québec du CHU de Québec

Edeltraut Kröger, PhD: Researcher, Centre de recherche FRQ-S du CHU de Quebec, Centre d'excellence sur le vieillissement de Québec

Justine Giosa, PhD(c): School of Public Health and Health Systems, University of Waterloo

Marie-Josée Sirois, PhD: Assistant Professor, Department of Rehabilitation and Medicine, Université Laval

Past CFN projects

Based on previous funding from the CFN, we conducted research in the following key areas:

  • Engaging older adults in healthcare research and planning, as well as in healthcare decision-making;
  • A screening tool to identify at-risk older adults in primary care;
  • Implementing a model of care-coordination in primary care; and
  • Implementing a framework to support patient engagement in care settings.
CFN
RCE