Falls are among the most serious and common threats to older peoples’ independence. To reduce this threat, a pioneering Integrated Falls Prevention Pathway was developed in the Community Health Organisation for Cork and Kerry (CHO4). It integrates new multifactorial risk assessment clinics and follow-up intervention services through a single point of access. However, at present referrals are generated by a small number of individual health professionals and approximately 10% are unsuitable for assessment. Implementation has focused on increasing capacity in risk assessment and there is a dearth of information on whether older people are provided with recommended interventions following assessment.
We will examine ways to improve uptake of a single point of access to services on the pathway by health professionals, and investigate whether evidence-based interventions are provided to at-risk older adults following assessment.
We will co-design a referral protocol with knowledge users and referrers including GPs, Public Health Nurses, emergency department staff, physiotherapists and occupational therapists.
A mixed methods design will be used to determine the impact and feasibility of the strategy. Administrative data on the volume, spread and suitability of referrals will be analysed using interrupted time series analysis. Data will be integrated with qualitative findings from interviews with referrers on the feasibility of the strategy. We will retrospectively examine a purposive random sample of cases assessed at falls risk assessment clinics between 2016 and 2017 to determine if and when recommended interventions were delivered, using telephone surveys with local community and primary care providers.
This service is the sole example of an operational integrated falls pathway in Ireland. We will address an immediate information gap for the knowledge user, generating evidence on the strategies and resources needed to sustain and scale this model of care across the system to prevent falls among older people.
