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Increasing Referrals to a Community Paramedicine Fall Prevention Program Through Implementation of a Daily Management System

Ontengco, Julianne B., DNP, ANP-C

doi: 10.1097/JTN.0000000000000415

This quality improvement project was undertaken to improve trauma service referral compliance to an existing home-based elderly fall prevention program through the implementation of a daily management system (DMS). Operational excellence, a hospital-wide initiative, provided the foundation for improvement efforts. This initiative went through a series of 5 plan, do, study, and act (PDSA) cycles and demonstrated significant improvement in referrals from 0% to 100%. Compliance with referrals after the retirement of the key performance indicator remained high at 95.5%. Results from this project provided support for the framework set forth in DMS and PDSA improvement methodologies as a feasible option to implement quality and process improvement projects. Further study in this area is warranted.

Division of Trauma, Department of Surgery, Maine Medical Center, Portland; and University of Southern Maine, Portland.

Correspondence: Julianne B. Ontengco, DNP, ANP-C, Division of Trauma, Department of Surgery, Maine Medical Center, Ste R-1101, 22 Bramhall St, Portland, ME 04102 (

The author acknowledges and expresses gratitude to the members of the Maine Medical Center Trauma Team for their unique contributions to implementation and evaluation of this project. Furthermore, the author thanks Tania Strout, PhD, RN, and Deborah Hoch, DNP, for their unique contributions toward the statistical analysis and guidance throughout the project.

The author has no conflicts of interest.

Copyright © 2019 by the Society of Trauma Nurses.