title: An Interprofessional Approach to Reducing the Risk of Falls Through Enhanced Collaborative Practice.
abstract: Falls are the leading cause of accidental deaths in older adults and are a growing public health concern. The American Geriatrics Society (AGS) and British Geriatrics Society (BGS) published guidelines for falls screening and risk reduction, yet few primary care providers report following any guidelines for falls prevention. This article describes a project that engaged an interprofessional teaching team to support interprofessional clinical teams to reduce fall risk in older adults by implementing the AGS/BGS guidelines. Twenty-five interprofessional 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 1 year. The workshop focused on evidence-based strategies to decrease the risk of falls, including screening for falls; assessing gait, balance, orthostatic blood pressure, and other medical conditions; exercise including tai chi; vitamin D supplementation; medication review and reduction; and environmental assessment. Quantitative and qualitative data were collected using chart reviews, coaching plans and field notes, and postintervention structured interviews of participants. Site visits and coaching field notes confirmed uptake of the strategies. Chart reviews showed 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, and 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.
authors.affiliation: School of Medicine, Oregon Health & Science University, Portland, Oregon.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Eckstrom
authors.affiliation: Institute on Aging, Portland State University, Portland, Oregon.
authors.forename: Margaret B
authors.initials: MB
authors.lastname: Neal
authors.affiliation: School of Social Work, Portland State University, Portland, Oregon.
authors.forename: Vicki
authors.initials: V
authors.lastname: Cotrell
authors.affiliation: School of Medicine, Oregon Health & Science University, Portland, Oregon.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Casey
authors.affiliation: School of Nursing, Oregon Health & Science University, Portland, Oregon.
authors.forename: Glenise
authors.initials: G
authors.lastname: McKenzie
authors.affiliation: School of Medicine, Oregon Health & Science University, Portland, Oregon.
authors.forename: Megan W
authors.initials: MW
authors.lastname: Morgove
authors.affiliation: College of Pharmacy, Oregon State University, Corvallis, Oregon.
authors.forename: Gary E
authors.initials: GE
authors.lastname: DeLander
authors.affiliation: College of Pharmacy, Oregon State University, Corvallis, Oregon.
authors.forename: William
authors.initials: W
authors.lastname: Simonson
authors.affiliation: School of Medicine, Oregon Health & Science University, Portland, Oregon.
authors.forename: Kathie
authors.initials: K
authors.lastname: Lasater
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019983:Guideline Adherence / Q000458:organization & administration; D006284:Health Plan Implementation / Q000458:organization & administration; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D008134:Long-Term Care / Q000458:organization & administration; D008297:Male; D009922:Oregon; D010348:Patient Care Team / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration; D018570:Risk Assessment / Q000379:methods* / Q000458:organization & administration
keywords: falls prevention; implementation science; interprofessional education