Effect of a Falls Quality Improvement Program on Serious Fall‐Related Injuries. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Ganz, David A.; Kim, Sung‐Bou; Zingmond, David S.; Ramirez, Karina D.; Roth, Carol P.; Jennings, Lee A.; Mori, Takahiro; Keeler, Emmett B.; Wenger, Neil S.; Reuben, David B.
• Is Part Of: Journal of the American Geriatrics Society. Volume 63:Issue 1(2015:Jan.)
• Page Start: 63
• Page End: 70
• Publication Date: 2015-01
• Subjects: Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.13154
• Languages: English
• ISSNs: 0002-8614

Abstract

<abstract abstract-type="main" id="jgs13154-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jgs13154-sec-0001" sec-type="section"> <title>Objectives</title> <p>To determine whether a program that improves the quality of care for falls reduces the number of episodes of care for serious fall‐related injuries.</p> </sec> <sec id="jgs13154-sec-0002" sec-type="section"> <title>Design</title> <p>Nonrandomized controlled trial.</p> </sec> <sec id="jgs13154-sec-0003" sec-type="section"> <title>Setting</title> <p>Four community‐based primary care practices.</p> </sec> <sec id="jgs13154-sec-0004" sec-type="section"> <title>Participants</title> <p>Individuals aged 75 and older who screened positive for fall risk.</p> </sec> <sec id="jgs13154-sec-0005" sec-type="section"> <title>Intervention</title> <p>A multicomponent quality improvement program (Assessing Care of Vulnerable Elders Practice Redesign for Improved Medical Care for Elders) involving face‐to‐face clinician education about falls and decision support to prompt primary care providers to implement appropriate care, including referral to appropriate community resources, in response to individuals screening positive for fall risk.</p> </sec> <sec id="jgs13154-sec-0006" sec-type="section"> <title>Measurements</title> <p>Episodes of care for selected fall‐related injuries, based on healthcare claims.</p> </sec> <sec id="jgs13154-sec-0007" sec-type="section"> <title>Results</title> <p>Of 1, 791 individuals with data available for analysis, 1, 187 were in the intervention group, and 604 were in the control group. Mean age was 83, and more than two‐thirds of the sample were women. After adjusting for potential confounders, there were no statistically significant differences between intervention and control groups in episodes of care for fall‐related injuries during the 12‐month (incidence rate ratio (IRR) 1.27, 95% confidence interval (CI) = 0.93–1.73) or 24‐month (IRR 1.18, 95% CI = 0.93–1.49) period after initiation of the intervention.</p> </sec> <sec id="jgs13154-sec-0008" sec-type="section"> <title>Conclusion</title> <p>Despite improving the care of falls, this quality improvement initiative did not result in a change in the number of episodes of care for serious fall‐related injuries. Future work in community‐based settings should test higher‐intensity interventions to reduce fall‐related injuries.</p> </sec> </abstract>