Considerations for Developing Patient-centered Clinical Decision Support: Preventing Older Adult Falls after...

Area of Science:

• Gerontology
• Health Informatics
• Public Health

Background:

• Falls are a significant health concern for older adults, leading to injury and reduced quality of life.
• Emergency Departments (EDs) are critical touchpoints for identifying and intervening in fall risks among the elderly.
• Clinical Decision Support (CDS) tools offer potential for systematic fall prevention strategies within ED settings.

Purpose of the Study:

• To gather feedback from older adults on an ED-based CDS tool designed for fall prevention.
• To understand patient perceptions of automated risk screening and the tool's content.
• To identify patient-reported barriers to following up with recommended Falls Clinics.

Main Methods:

• Qualitative study involving interviews with 15 older adults during their ED stay.
• Elicited feedback on the written and verbal components of the existing CDS tool.
• Explored patient feelings regarding automated risk screening and identified barriers to clinic follow-up.

Main Results:

• Older adults perceived the CDS tool as an extension of their ED physician/APP's interaction.
• Key barriers to Falls Clinic follow-up included practical issues like transportation availability and clinic proximity.
• Patient trust in the healthcare provider's interaction with the CDS tool was evident.

Conclusions:

• For ED-based CDS tools to effectively prevent falls, patient needs and limitations must be integrated into intervention design.
• Addressing practical access barriers is crucial for improving patient adherence to post-ED fall prevention recommendations.
• Future CDS tool development should prioritize patient-centered approaches to enhance real-world impact on fall outcomes.