Improving Falls Clinic client engagement in falls prevention activities (2004-current)

NARI is working with three Falls Clinics to identify strategies to improve engaging Falls Clinic clients in activities identified as likely to minimise future risk of falling for the individual, thereby improving client safety. The project is being funded through the Safety Innovations In Practice Program (MK III), Australian Safety and Quality Council. A recent study undertaken by NARI found only about 60% of interventions recommended by Falls Clinics were fully undertaken by clients and around 40% of clients did not return for a follow-up assessment. These data suggest that there is a need to explore current practice and strategies to more actively engage Falls Clinic clients in falls prevention activities. In part, this will require investigation of the relevance of interventions to clients, their perceptions of the value and likely effect of these interventions, and perceived barriers to engaging in the interventions.

Falls Clinic clients will be asked to complete a survey exploring their expectations and experiences of the Falls Clinic. Clients who do not return for a follow-up assessment will be telephoned and asked to participate in a brief telephone interview exploring their experience of the Falls Clinic. A set of resources and a brief report will be developed outlining the key findings and strategies identified in the project. The resources will include a framework for engaging Falls Clinic clients in recommended falls prevention activities and a set of recommendations that could be applied by any Falls Clinic. An advisory group will oversee the project and will include Falls Clinic clients and a representative from the Consumers Health Forum of Australia. This will provide an opportunity for consumers to have input into the methodology, analysis and outcomes of the project.

Minimum Data Set project (2002-2004)

This project trialed the use of the Falls Clinic Minimum Data Set (MDS) developed in a previous NARI project, "Evaluation of Falls Clinics and development of a measurement and outcomes framework". The aim of the trial was to evaluate the utility of the MDS in identifying key outcomes for Falls Clinics. A common MDS of outcome measures will foster multi-centre research by providing comparable data across clinics.

Fourteen Victorian Falls Clinics participated in a 12-month data collection period collecting MDS measures at initial and 6-month follow-up assessments for 254 Falls Clinic clients. There was a significant reduction in the number of falls (64% reduction) and falls causing injuries (75% reduction). In addition, there were small but significant improvements in most of the secondary outcome measures, including balance, gait and mobility, leg strength, fear of falling, and reduced number of medications taken. The issue of client compliance with recommended interventions was also measured, and although compliance was overall fairly high (74%) there were some types of recommendations that warranted further investigation of factors that could be barriers to client engagement.

Funded by DHS Acute and Sub-Acute Health Branch

The final report "Evaluation of a Minimum Data Set for Victorian Falls Clinics" is available here .... (~1,187KB)
or at the Victorian Government Health Information / Sub-acute care web site, link here ....

The measures included in the MDS are outlined in the table below:

Evaluation of Falls Clinics (2001/2)

In 2001, the National Ageing Research Institute undertook an evaluation of Victorian Falls Clinics through funding from the Victorian Department of Human Services. The aims of this project were to:
o review the research literature (published, as well as conference proceedings and project reports) to describe the research evidence about the effectiveness of Falls Clinics;
o evaluate outcomes from three Victorian Falls Clinics to identify effectiveness of interventions across a range of key outcome measures;
o review assessment procedures currently used in Falls Clinics in Victoria with the aim of developing recommendations for a minimum data set of outcome measures; and
o provide a snapshot of issues associated with clients who do not attend 6 month review appointments at Falls Clinics.

An additional component to this project involved an evaluation of movement disorders Clinics. Movement Disorders Clinics provide a long term, multi-disciplinary case management approach for people with a broad range of progressive neurological disorders affecting movement. Most clients attending Movement Disorder Clinics have a diagnosis of Parkinson's disease or Huntington's disease. This evaluation reviewed research literature and analysed data available from one of the few Movement Disorders Clinics operating in Australia.

The Executive Summary "Evaluation of Falls Clinics and development of a measurement and outcomes framework & Review of Movement Disorder Clinics"for the project is available here ....
The full report is available here ....