Building Interprofessional Teams through Evidence Based Practice Training in Falls Prevention (original) (raw)
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An Interprofessional Approach to Reducing the Risk of Falls Through Enhanced Collaborative Practice
Journal of the American Geriatrics Society, 2016
Falls are the leading cause of accidental deaths in older adults and are a growing public health concern. The American Geriatrics Society/British Geriatrics Society (AGS/BGS) published guidelines for falls screening and risk reduction, yet few primary care providers report following any guidelines for falls prevention. This manuscript describes a project that engaged an interprofessional (IP) teaching team to support IP clinical teams to reduce fall risk in older adults via implementation of the AGS/BGS guidelines. Twenty-five IP clinical teams with representatives from medicine, nursing, pharmacy, and social work were recruited from ambulatory, long-term care, hospital, and home health settings for a structured intervention: a 4-hour training workshop plus "coaching" for implementation for one year. The workshop focused on evidence-based strategies to decrease the risk of falls, including screening for falls; assessing gait, balance, orthostatics and other medical conditions; exercise including tai chi; vitamin D supplementation; medication review and reduction; and environmental assessment. Quantitative and qualitative data were collected via chart review, coaching plans and field notes, and post-intervention structured interviews of participants. Site visits and coaching field notes confirmed uptake of the strategies. Chart reviews showed a significant improvement in adoption of all falls prevention strategies except vitamin D supplementation. Long-term care facilities were more likely to address environmental concerns and add tai chi classes while ambulatory settings were more likely to initiate falls screening. The intervention demonstrated that interprofessional practice change to target falls prevention can be incorporated into primary care and long-term care settings.
Interprofessional education model for geriatric falls risk assessment and prevention
BMJ Open Quality, 2018
BackgroundOne in three people over the age of 65 fall every year, with 1/3 sustaining at least moderate injury. Falls risk reduction requires an interprofessional health team approach. The literature is lacking in effective models to teach students how to work collaboratively in interprofessional teams for geriatric falls prevention. The purpose of this paper is to describe the development, administration and outcome measures of an education programme to teach principles of interprofessional care for older adults in the context of falls prevention.MethodsStudents from three academic institutions representing 12 health disciplines took part in the education programme over 18 months (n=237). A mixed method one-group pretest and post-test experimental design was implemented to measure the impact of a multistep education model on progression in interprofessional collaboration competencies and satisfaction.ResultsPaired t-tests of pre-education to posteducation measures of Interprofessio...
International Journal of Integrated Care, 2009
Background: Providing care for older home care clients 'at risk' of falling requires the services of many health care providers due to predisposing chronic, complex conditions. One strategy to ensure that quality care is delivered is described in the integrated care literature; interprofessional collaboration. Engaging in an interprofessional team approach to fall prevention for this group of clients seems to make sense. However, whether or not this approach is feasible and realistic is not well described in the literature. As well, little is known about how teams function in the community when an interprofessional approach is engaged in. The barriers and facilitators of such an approach are also not known. Purpose: The purpose of this qualitative study was to describe the experiences of five different health care professionals as they participated in an interprofessional team approach to care for the frail older adult living at home and at risk of falling. Methodology: This study took place in Hamilton, ON, Canada and was part of a randomized controlled trial, the aim of which was to determine the effects and costs of a multifactorial and interdisciplinary team approach to fall prevention for older home care clients 'at risk' of falling. The current study utilized an exploratory descriptive design to answer the following research questions: how do interprofessional teams describe their experiences when involved in a research intervention requiring collaboration for a 9-month period of time? What are the barriers and facilitators to teamwork? Four focus groups were conducted with the care-provider teams (n=9) 6 and 9 months following group formation. Results: This study revealed several themes which included, team capacity, practitioner competencies, perceived outcomes, support and time. Overall, care providers were positive about their experiences and felt that through an interprofessional approach benefits could be experienced by both the provider and the patient and his/her family. Findings from this study suggest that research needs to be conducted to further explore the issues faced by this group of care providers and potential client outcomes.
Health Services Research, 2019
ObjectiveTo evaluate the implementation and outcomes of evidence‐based fall‐risk‐reduction processes when those processes are implemented using a multiteam system (MTS) structure.Data Sources/Study SettingFall‐risk‐reduction process and outcome measures from 16 small rural hospitals participating in a research demonstration and dissemination study from August 2012 to July 2014. Previously, these hospitals lacked a fall‐event reporting system to drive improvement.Study DesignA one‐group pretest‐posttest embedded in a participatory research framework. We required hospitals to implement MTSs, which we supported by conducting education, developing an online toolkit, and establishing a fall‐event reporting system.Data CollectionHospitals used gap analyses to assess the presence of fall‐risk‐reduction processes at study beginning and their frequency and effectiveness at study end; they reported fall‐event data throughout the study.Principal FindingsThe extent to which hospitals implemented 21 processes to coordinate the fall‐risk‐reduction program and trained staff specifically about the program predicted unassisted and injurious fall rates during the end‐of‐study period (January 2014‐July 2014). Bedside fall‐risk‐reduction processes were not significant predictors of these outcomes.ConclusionsMultiteam systems that effectively coordinate fall‐risk‐reduction processes may improve the capacity of hospitals to manage the complex patient, environmental, and system factors that result in falls.
International Journal of Environmental Research and Public Health
Falls in the home and in community environments are the leading cause of injuries and long-term disabilities for the aging population. The purpose of this study was to examine outcomes of a partnership among an academic institution, government agency, community organizations, and emergency management services to implement a falls prevention training program using an Age-Friendly Health Systems approach. In this prospective study, partners identified gaps in services and targeted and non-targeted delivery areas for implementation of an evidence-based falls prevention intervention addressing the 4Ms of Age-Friendly Health Systems—Mobility, Medications, Mentation, and What Matters. Descriptive statistics were calculated for program implementation and participant demographic variables, and paired t-test analysis compared scores for self-assessed general health and falls efficacy prior to and after program participation. Twenty-seven falls prevention classes were implemented, with over h...
Journal of Interprofessional Education & Practice, 2017
Fall prevention programs with exercise interventions and medication reviews improve short-term function for community-dwelling older adults with risk of falls. 1 We describe an Interprofessional Falls Risk Assessment Program for community-dwelling adults to teach students how to assess falls risk associated with poor balance and medications that increase falls risk. The primary objective of this program was to evaluate whether participation in this Interprofessional Falls Risk Assessment Program altered the attitudes toward collaborative team-based healthcare practice in physical therapist and pharmacist students. Second-year physical therapist students and third-year pharmacist students were involved with the program. The Interprofessional Falls Risk Assessment Program consisted of three sessions. Sessions 1 and 2 were held in an academic setting, and Session 3 was held at a local senior living facility. Fall risk assessments were initially practiced by students amongst themselves, then formally provided to elderly volunteers from the community, and finally were provided to residents at a senior living facility. Students' attitudes toward collaborative practice were assessed before and following the program using the Student Perception of Interprofessional Clinical Education (SPICE-R). We found that SPICE-R scores increased following participation in this program. The Interprofessional Falls Risk Assessment Program represents a new IPE resource to increase students' interprofessional attitudes, knowledge, and experience before they enter the healthcare workforce. Our results indicate that IPE using an Interprofessional Falls Risk Assessment Program has a positive influence on students' understanding of both their own and other healthcare professionals role within an interprofessional team.
Achieving the Triple Aim Through a Falls Prevention Innovation in Long-Term Care
Innovation in Aging, 2019
Falls disproportionately burden frail older adults in long-term care, which is evidenced by the 60% fall rate annually in this setting. Our health systems improvement model, framed by the Health Outcomes Model for falls prevention, is targeted to achieve the triple aim of better health, better care, and better value. Highlighting evidence from three inter-related studies, this presentation describes the impact of a practice change model and its impact on patient, unit/staff, and organizational level factors as related to facility-wide falls prevention. In study one, we used an evidenced-based practice approach and assessment tool to achieve total and recurrent falls reduction over one year by 32% and 25%, respectively (p<0.001). In study two, the annual savings of using this approach was assessed and showed a total savings of 53,531.00,whichequatesto53,531.00, which equates to 53,531.00,whichequatesto700.00 per falling person. In pilot study three, a convenience sample of 15 older adults who were interviewed about their fall...
Journal of Evaluation in Clinical Practice, 2010
Rationale, aims and objectives The incidence of falls and fall-related injuries in older age is predicted to increase concomitantly with global population ageing, representing a serious challenge to health care systems. In spite of the availability of policy and practice guidelines for the prevention of falls and fall-related injuries, a considerable gap remains between best practice and current health service delivery. This paper describes the method and results of the implementation and evaluation of a state-wide workforce enhancement strategy to promote the uptake of evidence-based falls prevention activities for older people. Methods The project was undertaken in Queensland, Australia in 2008 across the community, acute and residential aged care sectors. Six Falls Safety Officers (FSOs) were appointed to implement a 1-year pilot of strategies aimed at enhancing workforce capacity to deliver a coordinated approach to falls prevention across the care continuum. The project was independently evaluated for process, impact and outcome. Both quantitative and qualitative data were extracted from records maintained by the FSOs for the evaluation and additional data were obtained from interviews with key stakeholders. Results Considerable progress was achieved towards the project's objectives, including the wide dissemination of information and resources, as well as the establishment of working groups to continue falls prevention planning and implementation. Barriers and facilitators to the project's implementation were identified. Conclusion The formal evaluation provides evidence for the development of a crosscontinuum service delivery model for implementing coordinated state-wide falls prevention strategies for the prevention of falls in older people.