The RCA has released a report on its pilot of the post-fall rehabilitative care pathways for frail seniors.
The evidence-based care pathways for primary care and emergency departments are designed to connect frail older adults who fall with rehabilitative care to reduce functional decline and prevent additional falls. The pilot — taking place in Hamilton, Sudbury and Thunder Bay — will determine the simplest and most effective ways to embed the pathways into clinical practice.
Due to the COVID-19 pandemic, the pilot has been put on hold. However, the RCA has released the findings of the first PDSA cycle (three were planned). The report describes implementation strategies and tools used in the pilot to inform others who may be interested in implementing the pathways.
The report notes the following:
- The majority of participating clinicians indicated they did not have a secondary fall prevention protocol in place prior to the pilot. Most conducted a general assessment of a frail older adult who has fallen without using validated tools or outcome measures, and a chart review found most fall risk factors were not evaluated.
- Data submitted for PDSA Cycle #1 showed that use of the pathway led to a marked improvement on all aspects of the assessment, although there was room for improvement in the assessment of some fall risk factors. Data also showed that assessments were shared more consistently within the patient’s circle of care and that there was an increase in follow-up referrals to geriatric and rehabilitative care services.
Exploring pilot with community paramedics
The RCA will continue to consult with participating sites to assess if and when the pilot can resume. The RCA is also working with the Ontario Community Paramedicine Secretariat to determine whether the post-fall pathway can be adapted and piloted by community paramedics. Community paramedics are often called to assist people who have fallen, but if individuals choose not to be transported to a hospital, they may not receive follow-up. By implementing a post-fall pathway, paramedics could help people access appropriate rehab services to prevent another fall.
For more information, please contact Gabrielle Sadler, Project Manager.