Bringing Geriatrics to Primary Care
The Carolina Geriatric Workforce Enhancement Program is reaching out to primary care practices to ensure every provider has geriatrics knowledge. Between 2010 and 2015 we partnered with Mountain AHEC and faculty from Western Carolina University to implement standardized falls risk screening for all patients over the age of 65 in 3 physician practices in the western part of North Carolina. In the summer of 2012 we reported an increase of 37% in falls screening rates showing a demonstrated improvement in practice and ultimately outcomes. Our research results were featured in 2 posters at the Gerontological Society of America.
In 2016 we expanded our efforts and are coaching and training healthcare providers across the state in geriatic care management. Piedmont Health Services is conducting a rapid cycle quality improvement project on falls prevention, In Wilmington we are working with the internal medicine residency to increase the number of older adults who have advance care directives. Other sites in Wake County and near Charlotte are planning projects on polypharmacy and reducing caregiver stress.
Today we are active with over 31 primary care practices working to improve falls screening and intervention rates, the number of advance care planning conversations primary care providers have with their patients and ultimately the completion of these important documents.
Working with Emergency Medical Services
The CGWEP also trained a special team of EMS workers in Orange County on falls prevention. The Orange County Department on Aging has partnered with the CGWEP and EMS to create a service pattern network under which frequent fallers who call EMS have additional follow up. After the training EMS workers conduct a second home visit and perform a multifactorial falls risk assessment. Patients who screen positive receive follow up from a Case Manager at the Department on Aging who facilitate referrals and access to community services. This project not only represents another falls prevention intervention at another point on the service continuum but is also a change in service coordination and patterns linking agencies and health care providers in a much more coordinated system.
Working with Continuing Care Retirement Communities
With the goal of implementing evidence-based falls prevention strategies across the continuum of care, the CGWEP developed and presented content to train nurses and front line in continuing care retirement communities. Teaching standardized evidenced-based falls prevention techniques to multi-disciplinary teams significantly improved the quality of life for residents and increased the likelihood that these seniors would be able to remain living independently.
Working with the Community
Finally the CGWEP has supported pilot research conducted by Western Carolina, UNC Asheville, Mountain AHEC and the Western Carolina Falls Prevention Coalition to teach community members standardized falls prevention techniques. Researchers are determining if lay people can make a difference in helping prevent falls among the elderly. During Falls Prevention Awareness Week community volunteers are trained to conduct falls screenings making safety and preventing accidents even more widely available.
For more information on our research projects or to involve your doctor’s office, retirement home or community group email Christine Henage, Ed.D.