Stakeholder and Data-Driven Fall Screen in a Program of All-Inclusive Care for the Elderly: Quality Improvement Initiative.
Allison M Gustavson, Jason R Falvey, Cherie V LeDoux and 1 others
PMID 33782362WHAT IT FOUND
In PACE participants, a Short Physical Performance Battery score of 1 to 7 flagged higher risk of falls and injurious falls than a score of 8 to 12.
The screen was built with clinicians and embedded in routine assessments.
Key findings
01Participants with a low SPPB score (1 to 7) had 79% greater risk of any fall and 86% greater risk of injurious fall than participants with a high score (8 to 12).
02During follow-up, participants experienced 1446 falls, with 421 in the high SPPB group and 1025 in the low SPPB group.
03A total of 1772 participants were screened from 2694 eligible participants, and 162 were excluded from the fall risk screen because they scored 0.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was done in 5 InnovAge PACE sites in Colorado, so it may not apply to other regions or other PACE programs. Fall counts came from facility incident reports, which may miss falls, especially non-injurious falls, so the fall rates may be conservative. The study evaluated whether the screen discriminated fall rates; it did not test an intervention. Participants who scored 0 on the SPPB were excluded from the fall risk screen, so the screen does not address non-ambulatory participants. Only 1772 of 2694 eligible participants were screened, so findings may not represent all PACE participants. The cut points were agreed through stakeholder discussion and clinical experience, and the paper notes that data for fall risk stratification in this population are lacking.
Declared interests
The authors state that they have no conflicts of interest.
The easy way to misread this
Do not read the higher fall rates in the low SPPB group as proof that the screen improves outcomes. The study described fall rates and risk groups, but it did not test whether acting on the screen reduced falls or injuries.