Obstacles and Future Research
- Poor concordance with the guidelines
- Changing the language
- Identifying the correct patient population
- Better, more specific screening tools
- Post-ED visit intervention and follow-up
NOTE
Despite awareness of the ACEP Guidelines, the recommendations are not being implemented in the ED. There are several reasons for this: lack of knowledge of the guidelines, perceived lack of time in the ED, and difficulty with the intervention as it takes many resources and remains unclear which interventions have the most impact. In addition, one study that surveyed ED providers in an academic institution found that most respondents were not familiar with the geriatric ED fall guidelines (66% not at all, 32% somewhat).
We also need to change the language from fall prevention, which seems vast and insurmountable to safe mobility.
Future research needs to determine what screening tools providers are willing to use, improve education among providers, and have a more streamlined intervention.
References
Tirrell G et al. Acad Emerg Med. 2015;22(4):461–467.
Carpenter CR et al. Acad Emerg Med. 2015;22(4):478–480.
Abbreviations
ACEP, American College of Emergency Physicians; ED, emergency department.