Implementing an Educational Intervention to Increase Fall Risk Screening in Primary Care

Abstract

Purpose: This quality improvement project aimed to provide an educational intervention for theEl Rio Pascua clinic staff regarding the importance and process of screening for future fall risk in adults 65 and older (older adults). Background: Falls are the leading cause of injury death in older adults in the United States, accounting for approximately 38,000 deaths annually. Over one in four older adults fall annually, and those who fall are at higher risk of additional falls. The cost of falls is approximately $50 billion per year, and there are over 3 million ED visits related to falls each year. Many falls are preventable, and exercise is the most effective intervention for reducing falls in older adults. Methods: This mixed methods quality improvement project included an educational intervention at the El Rio Pascua clinic all-staff meeting on August 21, 2024, and a follow-up on September 18, 2024. Pretests and posttests were completed by 14 of the 19 attendees of the August meeting. The pretests and posttests asked about participants’ role in the clinic, years working in the clinic, barriers to screening for fall risk before and after the intervention, and six Likert-Scale questions regarding participants’ understanding of the importance and process of screening for fall risk as well as their willingness to screen. Results: The El Rio Pascua clinic did not reach the 80% screening for future fall risk goal in September 2024, the month after the educational intervention. However, the pretest and posttest results showed a statistically significant increase in understanding of how to screen for fall risk in the electronic health record (EHR). The pretests and posttests also revealed themes in barriers to screening for future fall risk, including lack of patient buy-in, lack of accessible interventions for those at high risk of falling, and lack of time to screen for fall risk. Conclusions: Future quality improvement initiatives and research regarding screening for fall risk could be directed at understanding the lack of patient buy-in, increasing access to exercise interventions for positive screenings, and finding ways to screen within time constraints.