Details:

Alternative Title:
Gerontologist
Personal Author:
Casey, Colleen M. ; Parker, Erin M. ; Winkler, Gray ; Liu, Xi ; Lambert, Gwendolyn H. ; ... More +
Casey, Colleen M. ; Parker, Erin M. ; Winkler, Gray ; Liu, Xi ; Lambert, Gwendolyn H. ; Eckstrom, Elizabeth Less -
Description:
Background

Falls lead to a disproportionate burden of death and disability among older adults despite evidence-based recommendations to screen regularly for fall risk and clinical trials demonstrating the effectiveness of multifactorial interventions to reduce falls. The Centers for Disease Control and Prevention developed STEADI (Stopping Elderly Accidents, Deaths, and Injuries) to assist primary care teams to screen for fall risk and reduce risk of falling in older adults.

Purpose of the Study

This paper describes a practical application of STEADI in a large academic internal medicine clinic utilizing the Kotter framework, a tool used to guide clinical practice change.

Design and Methods

We describe key steps and decision points in the implementation of STEADI as they relate to the recommended strategies of the Kotter framework. Strategies include: creating a sense of urgency, building a guiding coalition, forming a strategic vision and initiative, enlisting volunteers, enabling success by removing barriers, generating short-term wins, sustaining change, and instituting change.

Results

Fifty-six patients were screened during pilot testing; 360 patients were screened during the first 3 months of implementation. Key to successful implementation was (a) the development of electronic health record (EHR) tools and workflow to guide clinical practice and (b) the proactive leadership of clinical champions within the practice to identify and respond to barriers.

Implications

Implementing falls prevention in a clinical setting required support and effort across multiple stakeholders. We highlight challenges, successes, and lessons learned that offer guidance for other clinical practices in their falls prevention efforts.


Keywords:
[+]
Clinical Decision Support Electronic Health Record Falls Risk Evaluation Falls Screening Implementation Science
Source:
Gerontologist.
Pubmed ID:
27130270
Pubmed Central ID:
PMC5940581
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHSUnited States/
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:d4b4404bdf47d0943b077a241a1a63b002f179861230e4df7a91181eb0ae31c3
Download URL:
https://stacks.cdc.gov/view/cdc/53833/cdc_53833_DS1.pdf
File Type:

Supporting Files

• 	NIHMS883401-supplement-Supplemental.docx	docx
  	nihms883401.nxml	xml
  	nihms883401f1.gif	gif
  	nihms883401f1.jpg	jpeg
  	nihms883401f2.gif	gif
  	nihms883401f2.jpg	jpeg

More +