Table 1

A summary of the participants, methods and key findings of the intervention study to test the clinical assessment tool (CAT)

Study period2003–2004
Development of CATTeam of clinicians (community, ambulance and acute backgrounds) and patient representatives.
Content of the CATThe CAT was designed to shadow the established format of prehospital guidelines but differed in providing a falls-specific assessment guide, prompts to conveyance or non-conveyance to the ED and a route of referral to the patient's GP.
Assessment of any ‘change in level of function which would impact on the ability to remain at home safely’, with function defined as physical, mental and social.
CAT study participantsAll EMTs and paramedics (n=213) based in eight ambulance stations (in four groups) in London: 61.1% male, median length of service 2 years.
Preparation of participants2-h training session on the causes of falls, assessment of the older person who has fallen, use of the CAT and research methods.
Nature of participationCompletion of a CAT for every patient meeting the definitions below for a 6-month patient recruitment period.
Use of the CAT was encouraged during training and by the study researchers, but staff were not held to account for non-use.
DefinitionsA fall: ‘Inadvertently coming to rest on the ground or other lower level with or without loss of consciousness and other than as a consequence of sudden onset of paralysis, epileptic seizure or overwhelming external force.’
An older person=aged 65 and over
Evaluation of the CAT: tool useUse in practice varied between staff members, with 22.8% of the participating staff completing the tool in all appropriate cases they attended, 47.8% in some and 29.4% in no cases.
Evaluation of the CAT: impact on ‘adverse events’A statistically significant reduction in adverse events (reattendance by the ambulance service or to the ED, or death) during the study period was found when compared with baseline data9 (34.6% intervention period vs 49.1% baseline period; χ2 11.208, p=0.001).