HealthDay News — An intervention targeting gaps in staff communication and coordination (complexity science-based staff training intervention [CONNECT]) does not improve the impact of an evidence-based falls quality improvement program (FALLS), according to a study published online in JAMA Internal Medicine.
Cathleen S. Colón-Emeric, MD, from Duke University Medical Center in Durham, North Carolina, and colleagues conducted a cluster-randomized trial in 24 nursing homes receiving CONNECT followed by FALLS (intervention) or FALLS alone (control). Nursing home staff completed surveys at baseline as well as 3, 6, and 9 months; 1545 staff members completed surveys (734 [37%] and 811 [44%] of eligible staff in intervention and control facilities, respectively). Medical records were abstracted for 1794 residents with at least one fall in the 6-month pre- and post-intervention windows.
The researchers found that after FALLS, neither the CONNECT nor the FALLS-only facilities improved the mean count of fall reduction activities (3.3 vs 3.2 of 10); there was no difference between the groups in the adjusted median recurrent fall rates (4.06 vs 4.06 falls/resident/year). Overall, staff communication measures (mean, 0.03 points on a 5-point scale) and communication timeliness (mean, 0.8 points on a 5-point scale) improved modestly. Wide variation was seen across facilities in intervention penetration.
“New approaches to implementing evidence-based care for complex conditions in the nursing home are urgently needed,” the authors write.
Colon-Emeric CS, Corazzini K, McConnell ED, et al. Effect of promoting high-quality staff interactions on fall prevention in nursing homes: a cluster-randomized trial [published online October 2, 2017]. JAMA Intern Med. doi:10.1001/jamainternmed.2017.5073