Clinical decision making in the prediction of falls

Objective: Examine rehabilitation professionals' capacity to identify risk factors for patient falls. Design: Survey study. Setting: Three academic me dical center rehabilitation departments. Participants: Fifty-six rehabilita tion specialists representing disciplines typically involved in patient car e, including physiatry and occupational, physical, recreation, and speech t herapy. Measures: A 2-part, self-report questionnaire with spontaneous and cued rank-order listing of factors related to fall risk. Results: Clinician s did not consider advanced age and history of falling when spontaneously d elineating risks for falls. The importance of fall history, but not of adva nced age, was recognized through cueing. Conclusions: Clinicians appear awa re of strong predictors of fall risk but require cueing to consistently use them. Cueing increased hypothetical predictive accuracy, although clinicia ns still downplayed some of the most salient predictive factors. Staff educ ation regarding validated fall risk factors and potential errors in clinica l decision making can improve patient care.