Prof. Alison Pighills1,2, Dr Anna Tynan3,4,5, Ms Susan Melchert1, Ms Tessa Brondello2, Ms Alicia Eden2
1James Cook University, Townsville, Australia, 2Mackay Hospital and Health Service, Mackay, Australia, 3Darling Downs Health, Toowoomba, Australia, 4The University of Queensland, Toowoomba, Australia, 5University of Southern Queensland, Springfield Central, Australia
Biography:
Alison’s clinical background in Occupational Therapy and research track record have provided her with broad research methods literacy. She is internationally recognised as a research leader in environmental interventions for falls prevention in older people and has been the recipient of several research grants, with a career-funding total of $12 million.
Abstract:
Background:
Environmental assessment and modification (EAM) is an effective approach to reducing falls in older people, particularly when provided by occupational therapists to high risk populations. EAM has been incorporated into many national and international falls prevention guidelines; however, evidence suggests that it is not being implemented in practice. The aim of this study was to quantitatively evaluate the implementation of best practice EAM across two regional health services in Queensland, Australia between 2020-2022.
Method:
A pre and post implementation evaluation was carried out to determine penetration, adoption, staff acceptability and fidelity to training protocol of best practice EAM. Quantitative data were collected via occupational therapy staff questionnaires and audits of medical charts and Westmead Home Safety Assessment (WeHSA) forms. Descriptive statistics summarised data and inferential tests examined differences in outcomes pre and post intervention.
Results:
Analysis revealed that in one site there was a high degree of penetration, adoption, staff acceptability and protocol fidelity. However, on occasion, falls risk screening to determine eligibility for the WeHSA was applied too rigidly and appeared to replace clinical reasoning. This site embedded the new intervention into team processes to ensure that implementation was sustained. Implementation did not get beyond the initial staff training phase in the other site.
Conclusion:
Learnings from this study provide useful insights into the implementation of EAM in regional and rural contexts and will support the future implementation of this intervention.