{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:29:30Z","timestamp":1792193370534,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100023650","name":"Bureau of Health Workforce","doi-asserted-by":"publisher","award":["U1QHP28734"],"award-info":[{"award-number":["U1QHP28734"]}],"id":[{"id":"10.13039\/100023650","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["T35AG038047"],"award-info":[{"award-number":["T35AG038047"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The emergency department (<jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>) is an opportune setting for fall prevention interventions. We implemented and evaluated a multimodal falls prevention intervention addressing medications, mobility, and functional risk factors among older adults presenting to the <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> for fall\u2010related injuries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We implemented a quality improvement intervention at two hospitals among <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> visits for adults aged 65 and older with a chief complaint of fall between May 2023 and June 2024. The intervention included: (1) medication review by a pharmacist; (2) assessment by physical therapy (<jats:styled-content style=\"fixed-case\">PT<\/jats:styled-content>); and (3) assessment by occupational therapy (<jats:styled-content style=\"fixed-case\">OT<\/jats:styled-content>). We conducted a retrospective evaluation of electronic health records and reported the proportion of patients that received screening along with risk factors, recommendations, adherence to recommendations, and return visits at 3 and 6\u2009months. We used logistic regression to examine factors associated with return visits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 686 older adults who received \u2265\u20091 screening. Most patients received <jats:styled-content style=\"fixed-case\">PT<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">OT<\/jats:styled-content> evaluations (94.8% and 93.4%), while fewer (15.2%) received medication reviews. The most common problems identified by <jats:styled-content style=\"fixed-case\">PT<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">OT<\/jats:styled-content> were fall risk, decreased mobility, and impaired balance. Discharge to a skilled nursing facility was the most common recommendation (55.5% <jats:styled-content style=\"fixed-case\">PT<\/jats:styled-content>, 55.1% <jats:styled-content style=\"fixed-case\">OT<\/jats:styled-content>) followed by home care (33.1% <jats:styled-content style=\"fixed-case\">PT<\/jats:styled-content>, 31.2% <jats:styled-content style=\"fixed-case\">OT<\/jats:styled-content>). High\u2010risk medications most often identified were anticoagulants, antidepressants, and gabapentin. The most common recommendation was to \u201cdiscuss with a primary care physician.\u201d Among those who received \u2265\u20091 intervention, 8.9% experienced a return visit within 3\u2009months and 12.8% within 6\u2009months. Inpatient admission was associated with increased likelihood of return visits compared to discharge from the <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The most prevalent risk factors for falls among older adults presenting to the ED are likely modifiable through PT and OT intervention. Further research is needed to address uptake barriers and longitudinal impact on outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgs.19613","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T10:44:07Z","timestamp":1751021047000},"page":"2780-2788","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Multimodal Fall Prevention Intervention in the Setting of the Emergency Department"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1466-5751","authenticated-orcid":false,"given":"Joshua D.","family":"Niznik","sequence":"first","affiliation":[{"name":"Division of Geriatric Medicine University of North Carolina at Chapel Hill School of Medicine  Chapel Hill North Carolina USA"},{"name":"Center for Aging and Health University of North Carolina at Chapel Hill School of Medicine  Chapel Hill North Carolina USA"},{"name":"Division of Pharmaceutical Outcomes and Policy University of North Carolina at Chapel Hill Eshelman School of Pharmacy  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra","family":"Small","sequence":"additional","affiliation":[{"name":"Center for Aging and Health University of North Carolina at Chapel Hill School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7770-1639","authenticated-orcid":false,"given":"Casey J.","family":"Kelley","sequence":"additional","affiliation":[{"name":"Center for Aging and Health University of North Carolina at Chapel Hill School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"McMullen","sequence":"additional","affiliation":[{"name":"Center for Aging and Health University of North Carolina at Chapel Hill School of Medicine  Chapel Hill North Carolina USA"},{"name":"Division of Pharmaceutical Outcomes and Policy University of North Carolina at Chapel Hill Eshelman School of Pharmacy  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Anton","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of North Carolina at Chapel Hill School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Roberts","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine University of North Carolina at Chapel Hill School of Medicine  Chapel Hill North Carolina USA"},{"name":"Center for Aging and Health University of North Carolina at Chapel Hill School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Lourduraj","sequence":"additional","affiliation":[{"name":"Center for Aging and Health University of North Carolina at Chapel Hill School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5049-012X","authenticated-orcid":false,"given":"Martin F.","family":"Casey","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of North Carolina at Chapel Hill School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Busby\u2010Whitehead","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine University of North Carolina at Chapel Hill School of Medicine  Chapel Hill North Carolina USA"},{"name":"Center for Aging and Health University of North Carolina at Chapel Hill School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Davenport","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of North Carolina at Chapel Hill School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Centers for Disease Control and Prevention National Center for Injury Prevention and Control \u201cWeb\u2010Based Injury Statistics Query and Reporting System (WISQARS) \u201daccessed June 8 2023."},{"key":"e_1_2_11_3_1","unstructured":"Centers for Disease Control and Prevention \u201cBehavioral Risk Factor Surveillance System (BRFSS) \u201daccessed June 14 2023 https:\/\/www.cdc.gov\/brfss\/annual_data\/annual_2020.html."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2020.103564"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.21962"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2019-100732"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17375"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102017\u2010016358"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266\u2010013\u20100151\u20103"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2010.70redc"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.5770\/cgj.21.268"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.12974\/2309\u20106128.2015.03.01.2"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102019\u2010035978"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","unstructured":"T.Liu\u2010Ambrose J. C.Davis J. R.Best et\u00a0al. \u201cEffect of a Home\u2010Based Exercise Program on Subsequent Falls Among Community\u2010Dwelling High\u2010Risk Older Adults After a Fall A Randomized Clinical Trial \u201d321 no.21(2019):2092\u20132100 https:\/\/doi.org\/10.1001\/jama.2019.5795mu.","DOI":"10.1001\/jama.2019.5795"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101630.2009.00848.x"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2015.04.023"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12488"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14279"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40814\u2010019\u20100491\u20109"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16210"},{"key":"e_1_2_11_21_1","volume-title":"CDC STEADI: Evaluation Guide for Older Adult Clinical Fall Prevention Programs","author":"Bergen G.","year":"2019"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15767"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010494.pub2"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1089\/rej.2012.1397"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.5014\/ajot.2018.031252"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S43284"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2021.06.021"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41999\u2010021\u201000475\u20107"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18947"},{"key":"e_1_2_11_32_1","unstructured":"Centers for Medicare & Medicaid Services \u201cFY 2025 Hospital Inpatient Prospective Payment System (IPPS) and Long\u2010Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule\u2014CMS\u20101808\u2010F \u201daccessed August 1 2024 https:\/\/www.cms.gov\/newsroom\/fact\u2010sheets\/fy\u20102025\u2010hospital\u2010inpatient\u2010prospective\u2010payment\u2010systemipps\u2010and\u2010long\u2010term\u2010care\u2010hospital\u2010prospective\u20100."}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.19613","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T05:00:38Z","timestamp":1758776438000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.19613"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,27]]},"references-count":31,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/jgs.19613"],"URL":"https:\/\/doi.org\/10.1111\/jgs.19613","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,27]]},"assertion":[{"value":"2025-04-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}