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Problems with a great idea: referral by prehospital emergency services to a community-based falls-prevention service
  1. Tracy A Comans1,
  2. Michelle L Currin2,
  3. Jamie Quinn3,
  4. Vivienne Tippett4,
  5. Anthea Rogers2,
  6. Terry P Haines5
  1. 1School of Medicine & Griffith Health Institute, Griffith University, Brisbane, Queensland, Australia
  2. 2Metro South Community Health, Queensland Health, Brisbane, Queensland, Australia
  3. 3Australian Centre for Prehospital Research, Queensland Ambulance Service, Brisbane, Queensland, Australia
  4. 4School of Public Health, QUT, Brisbane, Queensland, Australia
  5. 5Physiotherapy Department, School of Primary Health Care, Monash University & Allied Health Research Unit, Southern Health, Melbourne, Victoria, Australia
  1. Correspondence to Dr Tracy A Comans, School of Medicine, Griffith University, University Drive, Meadowbrook, 4131, Queensland, Australia; t.comans{at}griffith.edu.au

Abstract

Background and aim Falls are the leading cause of injury in older adults. Identifying people at risk before they experience a serious fall requiring hospitalisation allows an opportunity to intervene earlier and potentially reduce further falls and subsequent healthcare costs. The purpose of this project was to develop a referral pathway to a community falls-prevention team for older people who had experienced a fall attended by a paramedic service and who were not transported to hospital. It was also hypothesised that providing intervention to this group of clients would reduce future falls-related ambulance call-outs, emergency department presentations and hospital admissions.

Methods An education package, referral pathway and follow-up procedures were developed. Both services had regular meetings, and work shadowing with the paramedics was also trialled to encourage more referrals. A range of demographic and other outcome measures were collected to compare people referred through the paramedic pathway and through traditional pathways.

Results Internal data from the Queensland Ambulance Service indicated that there were approximately six falls per week by community-dwelling older persons in the eligible service catchment area (south west Brisbane metropolitan area) who were attended to by Queensland Ambulance Service paramedics, but not transported to hospital during the 2-year study period (2008–2009). Of the potential 638 eligible patients, only 17 (2.6%) were referred for a falls assessment.

Conclusion Although this pilot programme had support from all levels of management as well as from the service providers, it did not translate into actual referrals. Several explanations are provided for these preliminary findings.

  • Fall
  • community research
  • economic analysis
  • programme evaluation
  • injury diagnosis
  • mechanism
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Footnotes

  • Funding The initial funding for this project was provided through the Qld Health Community Rehabilitation Workforce Project 2007 and subsequent funding through the Qld Health Strengthening Aged Care funding round 2007/08.

  • Competing interests None.

  • Ethics approval Princess Alexandra Hospital HREC.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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