Patient-stimulated fall prevention screening in primary care: analysis of provider coding changes

Area of Science:

• Geriatrics
• Public Health
• Primary Care Medicine

Background:

• The Centers for Disease Control and Prevention (CDC) developed the STEADI (Stopping Elderly Accidents, Deaths & Injuries) tool for fall risk screening.
• Slow adoption of the STEADI tool in routine clinical practice necessitates innovative implementation strategies.

Purpose of the Study:

• To enhance the screening of falls and fall risk within a busy academic internal medicine primary care setting.
• To evaluate the effectiveness of a patient-centered screening program integrated into routine clinical workflows.

Main Methods:

• A patient-centered screening program was implemented over three months, utilizing waiting room posters, STEADI Staying Independent questionnaires, and readily available fall prevention booklets.
• Unique identifiers on questionnaires and booklets, coupled with Epic Slicer-Dicer reports, facilitated the evaluation of falls screening-related ICD-10 codes.
• Generalized linear modeling was employed to compare coding rates with control clinics, analyzing the difference-in-difference.

Main Results:

• 255 questionnaires were taken, with 5 (2%) returned. 110 fall prevention booklets were distributed.
• An absolute difference-in-difference of 0.7% in ICD-10 coding was observed compared to control clinics.
• A statistically significant 4.7% increase in screening-related ICD-10 codes was identified (P < .0001) without workflow disruption.

Conclusions:

• Patient-centered screening in a busy academic practice may effectively increase falls-related ICD-10 coding.
• The integrated program was well-received by clinicians and demonstrated potential for improving fall risk identification.