Evidence map›Paper›PMID 38762531›Full record

ArticlePilot and feasibility studies2024

A protocol to determine the acceptability and feasibility of a pilot intervention emergency department virtual observation unit fall prevention program.

Abigail E Jones, Maura Kennedy, Emily M Hayden, Kei Ouchi, Kalpana N Shankar, Anita Chary, Angel Li, Kara Mc Loughlin, Benjamin White, Esteban Franco-Garcia and 2 more

Abstract read
In one paragraph

Article in Pilot and feasibility studies, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Abigail E JonesDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, USA.
Maura KennedyDepartment of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Emily M HaydenDepartment of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Kei OuchiDepartment of Emergency Medicine, Brigham and Women's Hospital, Boston, USA.
Kalpana N ShankarDepartment of Emergency Medicine, Brigham and Women's Hospital, Boston, USA.
Anita CharyDepartments of Emergency Medicine and Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA.
Angel LiValley Health System, Las Vegas, NV, USA.
Kara Mc LoughlinBeaumont Hospital, Dublin, Ireland.
Benjamin WhiteDepartment of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Esteban Franco-GarciaDepartment of Internal Medicine, Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, USA.
Vanessa DellheimMassachusetts General Hospital, Boston, USA.
Shan W LiuDepartment of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. sliu1@mgh.harvard.edu.ORCID http://orcid.org/0000-0002-5602-3717

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs a third of all community dwellers aged 65+ fall each year, falls are common reasons for older adults to present to an Emergency Department (ED). Although EDs should assess patients' multifactorial fall risks to prevent future fall-related injuries, this frequently does not occur. We describe our protocol to determine the feasibility, acceptability, and safety of a pilot ED Virtual Observation Unit (VOU) Falls program.

methodsTo ensure standardized conduct and reporting, the Standard Protocol Items for Intervention Trials (SPIRIT) guidelines will be used. The VOU is a program where patients are sent home from the ED but are part of a virtual observation unit in that they can call on-call ED physicians while they are being treated for conditions such as cellulitis, congestive heart failure, or pneumonia. A paramedic conducts daily visits with the patient and facilitates a telemedicine consult with an ED physician. VOU nursing staff conduct daily assessments of patients via telemedicine. The ED VOU Falls program is one of the VOU pathways and is a multi-component fall prevention program for fall patients who present after an ED visit. The paramedic conducts a home safety evaluation, a Timed Up and Go Test (TUG). During the VOU visit, the ED physician conducts a telemedicine visit, while the paramedic is visiting the home, to review patients' fall-risk-increasing drugs and their TUG test. We will determine feasibility by calculating rates of patient enrollment refusal, and adherence to fall-risk prevention recommendations using information from 3-month follow-up telephone calls, as well as qualitative interviews with the paramedics. We will determine the acceptability of the ED VOU Falls program based on patient and provider surveys using a Likert scale. We will ask VOU nursing staff to report any safety issues encountered while the patient is in the ED VOU Falls program (e.g., tripping hazards). We will use the chi-square test or Fisher's exact test for categorical variables, Student's t-test for continuous variables, and Mann-Whitney for nonparametric data. We will review interview transcripts and generate codes. Codes will then be extracted and organized into concepts to generate an overall theme following grounded theory methods. This is a pilot study; hence, results cannot be extrapolated. However, a definite trial would be the next step in the future to determine if such a program could be implemented as part of fall prevention interventions. DISCUSSION: This study will provide insights into the feasibility and acceptability of a novel ED VOU Falls program with the aim of ultimately decreasing falls. In the future, such a program could be implemented as part of fall prevention interventions.

Indexed as

FallsFeasibilityGeriatricTransitions of care

Identifiers

PMID38762531
PMCPMC11102199

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.