An Implementation Plan for a Falls Prevention Guideline in Residential Aged Care Facilities

Introduction

Falls are common high-impact problems in residential aged care facilities (RACFs), posing risks of injury, functional decline, and reduced quality of life. Although many countries have issued falls prevention guidelines for RACFs, their implementation in routine care remains challenging. We address this gap by presenting the development of a multifaceted plan aimed at supporting systematic implementation of a falls prevention guideline in RACFs.

Methods

The implementation plan was developed within the context of a large-scale falls prevention implementation project in Flanders (Belgium). Its design drew on existing research and followed the six stages of Intervention Mapping: (1) logic model of the problem, (2) logic model of change, (3) programme design, (4) programme production and testing, (5) programme implementation plan, and (6) evaluation plan. A stakeholder group of experts (n=9) was actively involved throughout the development process. The plan was pilot-tested in six RACFs and subsequently refined to enhance its relevance and feasibility within their context.

Results

The final plan consists of three phases and seven steps. The preparation phase (steps 1–3) helps RACFs build organisational commitment, analyse current practices, and define priorities. The implementation phase (steps 4–5) outlines how RACFs can execute targeted actions tailored to their needs and resources. The sustainment phase (steps 6–7) supports monitoring of progress, adapting actions, and integrating falls prevention interventions into daily routines and quality management systems to ensure long-term sustainability. An implementation facilitator supports the entire process, for up to 65 hours funded by the Flemish government.

Conclusions

This study resulted in a comprehensive implementation plan to assist RACFs in adopting and maintaining multifactorial falls prevention interventions. Future research should examine large-scale implementation and evaluate the plan’s effectiveness in preventing falls, including the added value of an implementation facilitator and its impact on determinants, implementation processes, and clinical outcomes.