Table 2.
Study instruments and timeline of assessments
| Instrument | Description | Administration |
|---|---|---|
| Process evaluation | ||
| Screening, eligibility, and retention | • Records how many patients were screened, agreed to participate, were recruited, received intended treatment, and were retained | • Baseline, 180 days |
| ED component and fidelity | • Records index visit ED LOS, time between consult call and arrival of pharmacist and PT, length of each consult, accuracy and completeness of action plan compared to the protocol | • Baseline |
| Patient, caregiver, and clinician feedback | • Tracks satisfaction with each component of the evaluation, perceived barriers and facilitators, and collects suggestions for improvement of the intervention | • Baseline |
| Follow-up component | • Tracks follow-up phone and in-person sessions with the research staff, PT, and any home services. Records uptake of recommendations made on the action plan for intervention participants | • 30, 90, 180 days |
| Outcome evaluation—feasibility, fidelity, and initial efficacy | ||
| Enrollment questionnaire |
• Demographic characteristics (includes marital status, whether the patient lives alone or with others, educational attainment, current employment.) • Prior fall history, comorbidities, ED index visit fall circumstances, and injuries |
• Baseline • < 5 min |
| Six-Item Screener (SIS) [19] | • 6-point questionnaire to measure cognitive impairment for study screening [19], < 4 indicates high risk for cognitive impairment |
• Baseline • 2 min |
| Timed Up and Go (TUG) test [21] |
• Timed test of how long it takes the patient to get up from a chair, walk 10 feet, and return to the chair • Validated measure of current function, balance, and fall risk • A TUG > 12 seconds identifies those patients at greater risk for subsequent falls |
• Baseline, 180 days • < 5 min |
| Barthel Index for Activities of Daily Living (ADL) [22] |
• Used to assess functional independence [22] • Information can be gained by self-report or caregiver report |
• Baseline, 30, 90, 180 days |
| Tinetti [23] |
• Validated measure of gait and balance • Predicts falls |
• Baseline • < 5 min |
| 5 Times Sit to Stand [24] | • A measure of functional lower limb muscle strength | • Baseline |
| AM-PAC “6-clicks” | • Test of activity limitations and function [25] used to help determine need and intensity of outpatient services such as PT, safety of discharge, and to predict falls and healthcare utilization |
• Baseline • 1 min |
| Falls Efficacy Scale-International [26] | • Measures fear of falling, which increases fall risk | • 180 days |
| Medication questionnaire | • Records all current and new prescriptions, over-the-counter and herbal medication, recommendations made by the pharmacist, recommendations accepted by the patient, and date of initiation/cessation |
• Baseline, 180 days • 25 min |
| Outcome instrument |
• Records follow-up falls and injuries by self-report and EHR review • Records subsequent ED visits and hospitalizations |
• 30, 90, 180 days • 5 min |
ED emergency department, LOS length of stay, SIS Six-Item Screener, TUG Timed Up and Go, ADL Activities of Daily Living, PT physical therapy, AM-PAC Activity Measure for Post-Acute Care, EHR electronic health record