Problems with a great idea : referral by prehospital emergency services to a community-based falls-prevention service

Comans, Tracy, Currin, Michelle, Quinn, Jamie, & Tippett, Vivienne (2011) Problems with a great idea : referral by prehospital emergency services to a community-based falls-prevention service. Injury Prevention, 19, pp. 134-138.

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Background and aim

Falls are the leading cause of injury in older adults. Identifying people at risk before they experience a serious fall requiring hospitalisation allows an opportunity to intervene earlier and potentially reduce further falls and subsequent healthcare costs. The purpose of this project was to develop a referral pathway to a community falls-prevention team for older people who had experienced a fall attended by a paramedic service and who were not transported to hospital. It was also hypothesised that providing intervention to this group of clients would reduce future falls-related ambulance call-outs, emergency department presentations and hospital admissions.


An education package, referral pathway and follow-up procedures were developed. Both services had regular meetings, and work shadowing with the paramedics was also trialled to encourage more referrals. A range of demographic and other outcome measures were collected to compare people referred through the paramedic pathway and through traditional pathways.


Internal data from the Queensland Ambulance Service indicated that there were approximately six falls per week by community-dwelling older persons in the eligible service catchment area (south west Brisbane metropolitan area) who were attended to by Queensland Ambulance Service paramedics, but not transported to hospital during the 2-year study period (2008–2009). Of the potential 638 eligible patients, only 17 (2.6%) were referred for a falls assessment.


Although this pilot programme had support from all levels of management as well as from the service providers, it did not translate into actual referrals. Several explanations are provided for these preliminary findings.

Impact and interest:

6 citations in Scopus
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6 citations in Web of Science®

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ID Code: 47121
Item Type: Journal Article
Refereed: Yes
DOI: 10.1136/injuryprev-2011-040076
ISSN: 1353-8047
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Primary Health Care (111717)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Schools > School of Public Health & Social Work
Copyright Owner: Copyright 2011 The Author(s)
Deposited On: 25 Nov 2011 00:44
Last Modified: 06 Nov 2013 05:05

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