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Poster Abstracts

A collective impact approach to co-designing an improved health care system for older adults with frailty and their caregivers in Southwestern Ontario


Kelly McIntyre Muddle

St. Joseph's Health Care London & Lawson Health Research Institute, CA
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In the South West (SW) region, there were a number of programs and initiatives focused on providing care for older adults at risk of/with frailty. Due to different funding streams, sectors and disease specific initiatives; the capacity to coordinate these efforts has been limited. This resulted in a disjointed experience of care for older adults with frailty and their caregivers, as they navigate a complex system. Through the regionally coordinated approach of the SW Frail Senior Strategy, the resources of the combined initiatives and programs are being leveraged to build an integrated, equitable. high quality system of care

Aims Objectives Theory or Methods

In the place of multiple committees supporting separate initiatives, one regional steering committee was formed using a cross sector, cross regional matrix for proper representation, including older adults and caregivers. A regional team was hired to provide backbone support.

Building on discovery research, the regional team co-designed with communities across the region to validate evidence-based recommendations, understand current state and identify change ideas.

Solutions generated were sorted and grouped to inform the development of five strategic priorities for 2019-2022. Implementation of these priorities has included expansion of the governance structure to include regional advisories and local design and implementation groups.

Highlights or Results or Key Findings

The 5 priorities of the Strategy include local and regional system redesign, planning and evaluation, education, advocacy, and communication/access to information.

By sunsetting the various committee of related initiatives, and replacing with one structure with cross-sectoral and cross-regional representation, the Strategy has been effective in supporting alignment across primary care, specialized care, community support services and local communities. To extend alignment locally and to support best-practice standardization, with local contextualization, the governance structure now includes regional advisory committees and local design and implementation groups.

With the regional scope and focus of this work requiring high levels of community engagement, the use of a collective impact framework, including backbone support provided by a dedicated team, and the employment of co-design and quality improvement tools and approaches has been instrumental in engaging providers and community members in all aspects of planning and implementation.


The SW Frail Senior Strategy provides a structure through which all initiatives with a focus on frail older adults can be reviewed for alignment with regional priorities – as identified through co-design - and strategically coordinated to optimize the creation of a more integrated and efficient system of care.

Implications for applicability/transferability sustainability and limitations

Best practice geriatric care requires system coordination and integration and collaboration across sectors. The regional collective impact approach employed by the SW Frail Senior Strategy will be of high interest to others who are interested in undertaking this work with a diverse population, urban/rural mix, and variable resources.

How to Cite: Muddle KM. A collective impact approach to co-designing an improved health care system for older adults with frailty and their caregivers in Southwestern Ontario. International Journal of Integrated Care. 2022;22(S2):147. DOI:
Published on 16 May 2022.


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