Dissertation Title: Alternative Care Pathways in The Management of Falls in The Prehospital Setting – Scoping Review
Research Methodology: Scoping literature review (qualitative evidence synthesis)
Research Design: Arksey and O’Malley–based scoping review using thematic analysis of included studies
Abstract
Background: Prehospital falls remain a major public health concern in many health systems, including the United Kingdom. Falls occurring before hospital contact place significant strain on emergency services, contribute to avoidable morbidity, and highlight the need for effective, community-based care strategies. In response, alternative care pathways have been increasingly explored to support fall prevention and early intervention outside the hospital setting.
Aim: The primary aim of this review was to examine the effectiveness of alternative care pathways used to manage falls in the pre-hospital environment. The study sought to identify the range of interventions available and evaluate their reported impact on fall prevention outcomes.
Methods: A scoping review methodology was adopted to systematically map the existing evidence. Literature searches were conducted across three major databases—MEDLINE, AMED, and CINAHL—known for their comprehensive coverage of paramedicine and nursing research. From an initial pool of 79 records, six studies met the inclusion criteria. The extracted evidence was synthesised using thematic analysis to identify recurring concepts and intervention strategies.
Results: Three key themes emerged from the included studies: multidisciplinary fall prevention programmes, falls-related educational interventions, and fall prevention technologies. The findings demonstrated that alternative care pathways vary in effectiveness, largely depending on patient acceptance, professional engagement, and contextual suitability. Multidisciplinary programmes were consistently identified as the most effective approach, as they integrate input from paramedics, nurses, and at-risk individuals, ensuring a holistic and coordinated response to fall management.
Conclusion: This review highlights that while several alternative pre-hospital fall prevention strategies exist, multidisciplinary approaches offer the most substantial benefits due to their collaborative nature and adaptability to patient needs. The findings support the wider adoption and integration of multidisciplinary fall prevention programmes to strengthen pre-hospital care pathways and reduce fall-related harm in community settings.