Hospital or home? Improving care for older people who have fallen

A computerised system to help paramedics make the right decision for older people who have fallen is safe, cost-effective and improves care for patients, according to new research from the College of Medicine.

400 x 498Calls to emergency ambulance services (999 calls) for falls contribute up to about 8% of the workload of Emergency Medical Services in the UK and internationally.

However many callers have no clinical need for treatment or investigation at an Emergency Department. 

Health policy in the UK encourages emergency ambulance services to offer alternatives to such callers.

But there is little evidence about the effectiveness, safety or cost-effectiveness of clinical assessment by paramedics.

Researchers in the College of Medicine have been working on the SAFER study, looking at computerised clinical decision support (CCDS), a technological innovation for emergency paramedics to use in the care of older people who have fallen

The aim was to test the effectiveness, safety (or avoidance of ‘harm’), and cost-effectiveness of CCDS.  13 ambulance stations in two UK emergency ambulance services took part in the research

Professor Helen Snooks of Swansea University College of Medicine, who led the project said:

“Results of our trial in two areas of the UK show that clinical computerised decision support for paramedics is safe, improves care for older people who fall and is potentially cost-effective, especially where services already have electronic data capture in place.  

Now we need to build on these internationally relevant findings to test this type of decision support in a wider group of 999 patients.”

The research paper is:  "Support and Assessment for Fall Emergency Referrals (SAFER 1): Cluster Randomised Trial of Computerised Clinical Decision Support for Paramedics"

Read the research paper, published in scientific journal PloS One

More about the SAFER study