Integrating STEADI for Falls Prevention in Outpatient Rehabilitation Clinics: An Outcomes Evaluation Using the RE-AIM Framework.
Background and Objectives The RE-AIM (Reach , Effectiveness , Adoption , Implementation , and Maintenance) framework was used to describe the implementation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) Initiative (2018–2021) for screening and assessing all older adults ≥65 years...
| Publicado en: | Gerontologist Vol. 64; no. 4; pp. 1 - 13 |
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| Autores principales: | , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Apr2024
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=176468939&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 176468939 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00169013 GET jtl: Gerontologist issn: 00169013 maglogo: N pubinfo: dt: Apr2024 vid: 64 iid: 4 pid: 622 pub: Oxford University Press / USA artinfo: ui: 176468939 10.1093/geront/gnad117 ppf: 1 ppct: 12 formats: tig: atl: Integrating STEADI for Falls Prevention in Outpatient Rehabilitation Clinics: An Outcomes Evaluation Using the RE-AIM Framework. aug: au: Vincenzo, Jennifer L Caulley, Jamie Scott, Aaron J Wilson, Brian S Wingood, Mariana Curran, Geoffrey M affil: Department of Physical Therapy, University of Arkansas for Medical Sciences Northwest , Fayetteville, Arkansas , USA Rehabilitation Services, Providence St. Joseph Health , Portland, Oregon , USA Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest , Springdale, Arkansas , USA Department of Implementation Science, Wake Forest University School of Medicine , Winston-Salem, North Carolina , USA Sticht Center for Healthy Aging and Alzheimer's Prevention, Internal Medicine, Gerontology and Geriatric Medicine, Wake Forest University School of Medicine , Winston-Salem, North Carolina , USA College of Pharmacy, University of Arkansas for Medical Sciences , Little Rock, Arkansas , USA Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System , North Little Rock, Arkansas , USA su: Evaluation of human services programs Elder care Evaluation of medical care Psychological adaptation Psychosocial factors Old age Mortality prevention Prevention of injury Clinical medicine Speech therapists Outpatient services in hospitals Occupational therapists Descriptive statistics Rehabilitation centers Conceptual structures Electronic health records Health outcome assessment Accidental falls Physical therapists Evaluation sug: subj: Evaluation of human services programs Elder care Evaluation of medical care Psychological adaptation Psychosocial factors Old age Continuing Care Retirement Communities All Other Outpatient Care Centers Offices of Physical, Occupational and Speech Therapists, and Audiologists Residential Mental Health and Substance Abuse Facilities Psychiatric and Substance Abuse Hospitals Other Individual and Family Services Mortality prevention Prevention of injury Clinical medicine Speech therapists Outpatient services in hospitals Occupational therapists Descriptive statistics Rehabilitation centers Conceptual structures Electronic health records Health outcome assessment Accidental falls Physical therapists Evaluation keyword: Balance Implementation science Injury prevention Balance Implementation science Injury prevention ab: Background and Objectives The RE-AIM (Reach , Effectiveness , Adoption , Implementation , and Maintenance) framework was used to describe the implementation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) Initiative (2018–2021) for screening and assessing all older adults ≥65 years for falls risk across 34 outpatient rehabilitation clinics within a large health system. Research Design and Methods We described the Implementation process and strategies. Using Electronic Health Records (EHRs), we identified Reach, Adoption, and Maintenance of screenings and physical assessments to identify fall risk among older adults. Results STEADI Implementation strategies included health system mandates, EHR revisions, email instructions, educational sessions and resources, clinical leads and champions, and chart audits. Reach: 76.4% (50,023) had a completed screening, and 44.1% screened at risk for falls. Adoption: Clinic-level adoption varied, with most performing screenings. Profession-level adoption was highest for physical therapists (PTs; 94.2% initiated, 80.6% completed) and lowest for speech-language pathologists (SLPs; 79.8% initiated, 55.9% completed). Reach and Adoption of functional outcomes measures (FOM): PTs completed an FOM on 59.5% of at-risk patients, occupational therapists on 11.6%, and SLPs on 7.9%. Maintenance: All measures declined 1%–10% annually between 2018 and 2021. Discussion and Implications STEADI screening and FOMs were implemented systemwide in 34 outpatient rehabilitation clinics, reaching over 50,000 older adults. Screening adoption rates varied by clinic. PTs had the highest adoption rate. All adoption rates declined over time. Future research should consider an implementation science approach with input from key partners before implementation to identify barriers and develop strategies to support STEADI in outpatient rehabilitation. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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