‘Service To reduce Risk, improve Independence and Decrease Emergency admissions’ – evaluation of an Advanced Practice Allied Health falls clinician role

Miss Lisa Oakley1, Mrs Valentina Maric1, Mrs Lisa  Somerville1,4, Professor Karen Smith2,3

1Alfred Health, Melbourne, Australia, 2Ambulance Victoria, , Australia, 3Monash University, Melbourne, Australia, 4LaTrobe University, Melbourne, Australia

Background: Approximately 40% of older adults over 65 fall in the community each year. Falls account for 16% of paramedic dispatches and are the leading cause of Emergency Department admissions for those over 65 within the targeted Alfred Hospital catchment. An opportunity emerged to pilot a new collaborative model of care between Alfred Health and Ambulance Victoria, a rapid falls response service.

Methods: The initial scope of the STRIDE service targeted low-acuity fallers, aged over 65 years, who called ‘000’ or presented to Alfred ED, within 24 hours of referral.  The advanced practice role involved a home visiting, solo practising, Occupational Therapist or Physiotherapist as a potential primary responder.  Clinicians were responsible for triaging, conducting a post-fall screen, completing a multi-factorial falls risk assessment and providing tailored interventions.

A risk analysis of the new model of care and a gap analysis of the clinician knowledge and skill requirements was conducted. This guided the development of an education framework, a performance standard and position description, reviewed and endorsed by the Alfred Health Scope of Practice Committee.

The service was piloted for a seven-month period and the advanced practice role was evaluated using process and qualitative measures.

Results: STRIDE advanced practitioners met transdisciplinary competency standards. Evaluation demonstrated STRIDE to be a beneficial service that meets a service gap in the community.  Key stakeholders positively supported the advanced practice role, the allied health focus, the rapid response and the delivery within the client’s home.

Discussion: A collaborative model of care and implementation of an advanced practice allied health falls clinician role can have positive impact on clients, health care utilisation and allied health professions. The design processes used to establish the collaborative model can be utilised to facilitate future service design.  The clinical education framework also has potential for future adaptation in other home-visiting Allied Health roles.


Biography:

Valentina Maric is a Physiotherapy Manager at Caulfield Hospital, Alfred Health. She has extensive clinical experience in rehabilitation having worked over 15 years in both private and public rehabilitation sector. She has completed a Master of Physiotherapy (Neurological Physiotherapy) and has a keen interest in preventing hospital admissions and enabling rehabilitation at home

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