A Multimodal Fall Prevention Intervention in the Setting of the Emergency Department

Area of Science:

• Gerontology
• Public Health
• Emergency Medicine

Background:

• The emergency department (ED) presents a unique opportunity for implementing fall prevention strategies for older adults.
• A multimodal intervention was developed to target medication, mobility, and functional risk factors in older adults experiencing fall-related injuries.

Purpose of the Study:

• To evaluate a quality improvement intervention for fall prevention in older adults presenting to the ED.
• To assess the impact of medication review, physical therapy (PT), and occupational therapy (OT) on fall risk factors and subsequent return visits.

Main Methods:

• A quality improvement intervention was implemented in two hospitals from May 2023 to June 2024.
• The intervention included pharmacist medication review, PT, and OT assessments for adults aged 65+ with fall-related chief complaints.
• Retrospective analysis of electronic health records examined screening rates, risk factors, recommendations, adherence, and return visits at 3 and 6 months.

Main Results:

• 686 older adults received at least one screening; PT and OT evaluations were common (94.8%, 93.4%), while medication reviews were less frequent (15.2%).
• Commonly identified issues included fall risk, decreased mobility, and impaired balance, with recommendations for skilled nursing facility or home care.
• Return visits occurred in 8.9% within 3 months and 12.8% within 6 months; inpatient admission was linked to higher return visit likelihood.

Conclusions:

• Physical therapy and occupational therapy interventions can effectively address prevalent fall risk factors in older adults presenting to the ED.
• Further research is necessary to overcome barriers to intervention uptake and understand the long-term effects on patient outcomes.