Evidence map›Paper›PMID 39394063›Full record

ArticleBMC emergency medicine2024

Strategies for implementation of a transmural fall-prevention care pathway for older adults with fall-related injuries at the emergency department.

W M Charmant, B A M Snoeker, H P J van Hout, E Geleijn, N van der Velde, C Veenhof, P W B Nanayakkara

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In one paragraph

Article in BMC emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
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

7 authors.

W M CharmantSection General Internal Medicine, Department of Internal Medicine, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands. w.m.charmant@amsterdamumc.nl.
B A M SnoekerSection General Internal Medicine, Department of Internal Medicine, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.
H P J van HoutAmsterdam Public Health Research Institute, Amsterdam, The Netherlands.
E GeleijnDepartment of Rehabilitation Medicine, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.
N van der VeldeAmsterdam Public Health Research Institute, Amsterdam, The Netherlands.
C VeenhofDepartment of Rehabilitation, Physical Therapy Science and Sport, Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
P W B NanayakkaraSection General Internal Medicine, Department of Internal Medicine, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.

Funding

Wetenschappelijk College Fysiotherapie, Amersfoort, the Netherlands 20201205
6 · The paper itself

Abstract

backgroundAlthough indicated, referrals for multifactorial fall risk assessments in older adults with fall related injuries presenting at the emergency department (ED) are not standard. The implementation of a transmural fall-prevention care pathway (TFCP) could bridge this gap by guiding patients to multifactorial fall risk assessments and personalised multidomain interventions in primary care. This study aims to develop and evaluate implementation strategies for a TFCP.

methodsIn this mixed-methods implementation study, strategies were developed using the Consolidated Framework for Implementation Research Expert Recommendations for Implementing Change Matching Tool. These were evaluated with patients, involved healthcare professionals, and other stakeholders using the Reach, Adoption, Implementation, and Maintenance of the RE-AIM framework in two cycles. Patients of the TFCP consisted of frail community dwelling individuals aged 65 and over presenting at the ED with fall related injuries.

resultsDuring the first implementation phase, strategies were focussed on assessing readiness, adaptability, local champions, incentives and education for all involved healthcare professions in the TFCP. Only 34.4% of eligible patients were informed of the TFCP at the ED, 30.6% agreed to a fall risk assessment and 8.3% patients received the fall risk assessment. In the second phase, this improved to 67.1%, 64.6%, and 35.4%, respectively. Strategies in this phase focussed on adaptability, obtaining sustainable financial resources, local champions, assessing readiness, and education. The implementation was facilitated by strategies related to awareness, champion recruitment, educational meetings, adaptability of TFCP elements and evaluations of facilitators and barriers.

conclusionThe study outlined strategies for implementing TFCPs in EDs. Strategies included increasing awareness, utilising local champions, educational initiatives, adaptability of the TFCP, and continuous monitoring of facilitators and barriers. These insights can serve as a blueprint for enhancing fall prevention efforts for older adults in emergency department settings.

Indexed as

Accidental FallsEmergency Service, HospitalAgedAged, 80 and overCritical PathwaysFemaleHumansMaleRisk AssessmentWounds and InjuriesEmergency departmentFall preventionImplementationOlder adultsTransmural care

Identifiers

PMID39394063
PMCPMC11470610

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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.