Dissemination of an Evidence-Based Multicomponent Fall Risk-Assessment and -Management Strategy Throughout a Geographic Area

摘要: OBJECTIVES: To report on the penetration of, and identified barriers to facilitators efforts incorporate evidence-based fall risk assessment management into clinical practice throughout a defined geographic area. DESIGN: Dissemination project. SETTING: North central Connecticut. PARTICIPANTS: Hospitals, home care agencies, primary providers, outpatient rehabilitation facilities. INTERVENTION: Multiple professional behavior-change strategies were used encourage providers their practices. MEASUREMENTS: Penetration of dissemination over 36 months; by provider working groups during first 2 years RESULTS: All seven hospitals 26 agencies in area, 119 130 facilities, 138 212 offices participated. Most expressed similar facilitating factors. Reported specific included lack awareness morbidity preventability, perceived expertise Medicare coverage, inadequate referral patterns among federal mandate for physicians. Facilitating factors falls opportunity market new services develop networks relationships across disciplines that focus functional outcomes. CONCLUSION: showed notable successes as well challenges. Although many general diffusing practices, several span sites. Project results have implications diffuse practices multifactorial geriatric conditions such falls.