VA Office of Research and Development
Walking speed is a powerful predictor of mortality and adverse health consequences (e.g. fall or hospitalization) in older adults. Knowledge of individuals' walking speed can provide unique insight into current physical function and need for healthcare services. Furthermore, walking speed is a modifiable risk factor such that early recognition of physical function decline allows for appropriate and timely intervention prior to the occurrence of adverse health events. Therefore, this proposal seeks to implement routine measures of walking speed into VHA primary care as a 'vital sign' to routinely monitor Veteran physical function and help guide provider referrals.
Background: Walking speed is a vital sign that can predict mortality and adverse health outcomes in older adults. However, it is not routinely assessed in outpatient primary care clinics, potentially leading to missed opportunities for timely intervention and rehabilitative care. Current literature identifies walking speed as a sensitive measure of overall health and functional status, with a walking speed of \<0.6 m/s indicating increased risk of adverse events and reduced independence. Consequently, knowledge of individuals' walking speed can provide unique insight into current physical func…
Inclusion Criteria: Site Inclusion Criteria: * VHA primary care clinics VHA Personnel Inclusion Criteria: * Providers working in a VHA primary care clinic where FASTER is implemented * Nursing staff working in a VHA primary care clinic where FASTER is implemented Veteran Inclusion Criteria: * Veterans 60 years and older receiving care in a VHA primary care clinic where FASTER is implemented Exclusion Criteria: * None
During the Usual Care phase, participating clinics will continue with usual care with the addition that walking speed will be measured and recorded. Veterans and providers will be blinded to walking speed measurement so as to not influence care.
During the FASTER phase, walking speed will be measured during clinic visits, recorded in the medical record, and used by providers to guide care. An Action Toolkit will be provided with resources for providers to support informed care decisions based on Veterans' walking speeds.
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