Date of Award

January 2021

Document Type

Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Lisa Corbett

Abstract

Falls have become a major public health concern. As the population ages, the prevalence of falls among older adults continues to increase, as does mortality and morbidity. Evidence-based assessment and intervention tools are widely available, though in practice, providers experience challenges utilizing them. Homebound older adults are at particular risk since they have mobility and transportation barriers that prevent access to community fall screening and primary care sites. This project focused on the provision of fall assessment, interventions, and coordination of fall-prevention services for community-dwelling, homebound older adults covered by a managed health plan. A standardized fall assessment and intervention pilot program using evidenced based tools was successful in reducing recurrent falls in this population by 50%. Based on the data analysis, a multidisciplinary approach with tailored care plans to mitigate recurrent falls in an older adult homebound population proved beneficial to members. The project provides a model for scalable adoption by managed care plans that coordinate care for medically complex, homebound older adults. Providing an adoptable multidisciplinary fall management model for managed care plans that coordinate members care will address the multifactorial risks and causes of falls, and tailor appropriate interventions.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 02/28/2022

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