Investigating facilitators and barriers to the implementation of Action Falls

Introduction: Falls are a prevalent issue impacting older people in care homes. Injuries can occur after a fall like fractures and there are many tools in use to manage patients who fall. However, few that focus on care home residents. Action Falls is a checklist that aids in diagnosing and highlighting risk of falls while providing healthcare professionals direct actions to take for prevention.  

Method:  Interviews were conducted over 4 weeks via Microsoft Teams. 3 doctors from each of the specialties Orthopaedics, General Practice, Geriatrics and 4 Psychiatrists were participants to a total 13. 30-minute semi-structured interviews had participants highlight what they identified as positives and negatives to the checklist. Following this, Braun and Clarke’s 6 steps thematic analysis was utilised after each interview was recorded, transcribed and manually coded to highlight themes and sub-themes. Secondary research into factors affecting the implementation of evidence-based research into clinical practice was investigated along with comparisons of alternative fall prevention tools. 

Results: 5 themes and 27 sub-themes were identified. Major themes included creating an electronic format for Action Falls and reducing length of the checklist. Almost all participants found the checklist useful with many positives identified, like having actions attached to each factor and a high level of detail aiding their understanding of falls. Many participants identified the checklist as laborious, concerned on how long it may take to fill out. 

Conclusion: Action Falls proved valuable, but with areas of improvement to increase uptake. Length was a consistent barrier pushing healthcare professionals away due to being viewed as more paperwork. One of the key strengths was its comprehensiveness with direct solutions. Further research on software integration into clinical practice is recommended to combat time and paperwork fatigue. Awareness of the tool was also seen to potentially enhance implementation.