Interprofessional education model for geriatric falls risk assessment and prevention.

BACKGROUND: One in three people over the age of 65 fall every year, with 1/3 sustaining at least moderate injury. Falls risk reduction requires an interprofessional health team approach. The literature is lacking in effective models to teach students how to work collaboratively in interprofessional teams for geriatric falls prevention. The purpose of this paper is to describe the development, administration and outcome measures of an education programme to teach principles of interprofessional care for older adults in the context of falls prevention. METHODS: Students from three academic institutions representing 12 health disciplines took part in the education programme over 18 months (n=237). A mixed method one-group pretest and post-test experimental design was implemented to measure the impact of a multistep education model on progression in interprofessional collaboration competencies and satisfaction. RESULTS: Paired t-tests of pre-education to posteducation measures of Interprofessional Socialization and Valuing Scale scores (n=136) demonstrated statistically significant increase in subscales and total scores (p<0.001). Qualitative satisfaction results were strongly positive. DISCUSSION: Results of this study indicate that active interprofessional education can result in positive student attitude regarding interprofessional team-based care, and satisfaction with learning. Lessons learnt in a rapid cycle plan-do-study-act approach are shared to guide replication efforts for other educators. CONCLUSION: Effective models to teach falls prevention interventions and interprofessional practice are not yet established. This education model is easily replicable and can be used to teach interprofessional teamwork competency skills in falls and other geriatric syndromes.

Clinical Outcomes in a Primary Care Practice Within a Center for Health Equity.

OBJECTIVE: A Center for Health Equity that included a primary care practice was built in a neighborhood affected by long-term disparities related to race and class in order to promote health equity within the population. Changes in blood pressure and HbA1c (glycated hemoglobin) over 2 years were examined to assess the impact of providing culturally appropriate and patient-centered care. METHODS: Data from June 1, 2012, to June 30, 2014 were obtained. Patients with high blood pressure or elevated HbA1c levels were treated according to evidence based guidelines. Blood pressure and HbA1c values at the first and last visit were compared using paired t tests. RESULTS: Of the 390 patients seen with a systolic pressure ≥140 mm Hg, 358 came back for at least 1 visit (92%). By the time of the last visit, 70% had values <140 mm Hg. Mean decreases for systolic and diastolic pressure between the first and last visit were statistically significant (both P < .001). Of the 88 patients seen with HbA1c values ≥7%, 68 came back for at least 1 visit (77%). By the last visit, 31% had values <7%. The change in mean HbA1c levels between the first and last visits was statistically significant (P = .001). CONCLUSION: Data from this report demonstrate statistically significant improved clinical outcomes among members of this community who sought and received care from physicians within this Center for Health Equity.