An Approach to Motivate Healthcare Providers to Adopt Tai Chi and Other Falls Prevention Strategies
August 19, 2016 -
Falls are the leading cause of accidental
deaths in older adults and are a growing public health concern. The American
Geriatrics Society (AGS) and British Geriatrics Society (BGS) published
guidelines for falls screening and risk reduction, which recommend Tai Chi as
one of the exercises. Yet few primary care providers report following any
guidelines for falls prevention.
Oregon Health & Science University, Portland
State University and Oregon State University jointly launched a project that
engaged an inter-professional teaching team to support inter-professional
clinical teams to reduce fall risk in older adults by implementing the AGS/BGS
Twenty-five inter-professional clinical
teams with representatives from medicine, nursing, pharmacy, and social work
were recruited from ambulatory, long-term care, hospital, and home health
settings for a structured intervention: a 4-hour training workshop plus coaching
for implementation for 1 year.
The workshop focused on evidence-based
strategies to decrease the risk of falls, including screening for falls;
assessing gait, balance, orthostatic blood pressure, and other medical conditions; exercise including Tai Chi;
vitamin D supplementation; medication review and reduction; and environmental
assessment. Quantitative and qualitative data were collected using chart
reviews, coaching plans and field notes, and post-intervention structured
interviews of participants.
Site visits and coaching field notes
confirmed uptake of the strategies. Chart reviews showed significant improvement
in adoption of all falls prevention strategies except vitamin D supplementation.
Long-term care facilities were more likely to address environmental concerns and
add Tai Chi classes, and ambulatory settings were
more likely to initiate falls screening.
The project demonstrated that
inter-professional practice change to target falls prevention can be
incorporated into primary care and long-term care settings.
This project is reported by Journal of the American Geriatrics Society in its August 2016 issue.