Enhancing referral processes within an integrated fall prevention pathway for older people: a mixed-methods study

Area of Science:

• Gerontology
• Health Services Research
• Public Health

Background:

• Multifactorial interventions for fall risk assessment necessitate cross-setting coordination.
• Effective onward referral pathways are crucial for successful intervention delivery.

Purpose of the Study:

• To develop a process map of onward referral pathways following falls risk assessment in primary care.
• To identify challenges and variations in managing referrals within integrated care.

Main Methods:

• A mixed-methods design combining focus groups with participatory mapping and analysis of administrative data.
• Qualitative data from primary care staff (public health nurses, physiotherapists, occupational therapists) and quantitative referral data were integrated.

Main Results:

• Nine staff participated in focus groups; 85 fall risk assessments were completed, with clients receiving an average of three onward referrals.
• Only 33% of referrals had available data on intervention receipt.
• Staff identified variations in referral management, lack of client information, inappropriate referrals, and inadequate data management support.

Conclusions:

• Challenges in onward referral pathways emerge early, particularly with clients having multiple risk factors.
• Lack of an integrated IT system for information sharing across settings poses a significant barrier.