Characteristic | Findings/values |
Study period | 2003–2004 |
Development of CAT | Team of clinicians (community, ambulance and acute backgrounds) and patient representatives. |
Content of the CAT | The 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 participants | All 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 participants | 2-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 participation | Completion 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. |
Definitions | A 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 use | Use 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). |