To improve care for falls and urinary incontinence (UI), Wenger and colleagues, in collaboration with the American College of Physicians, implemented the Assessing Care of Vulnerable Elders Practice Redesign for Improved Medical Care for Elders (ACOVEprime) intervention at five geographically diverse primary care practices. The intervention included screening of patients ages 75 and older for falls, fear of falling, or UI; establishing a clear plan for obtaining patient data; using a structured visit note to encourage health care providers to address the condition and collect data; providing patients and their families with educational materials and a local resources list; and supporting health care providers through educational programs.

A total of 1,211 patients were included in the intervention, 1,037 of whom indicated having fallen or fearing a fall, and 349 of whom had UI. Most were women (72%), and mean age was 83 years. Patients were nonrandomly selected to receive either intervention care or regular care (control group). The quality of care during the approximately one-year study period was measured using quality indicators (for example, care for a fall, examination and urinalysis for UI).

A total of 586 patients (57%) in the intervention group generated 2,974 quality indicators compared with 625 patients (36%) in the control group who generated 2,750 quality indicators. The intervention patients received significantly better care than the control patients in both falls (60% versus 38%, respectively) and in UI (47% versus 28%, respectively).

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