Case Study: Discovery Living Strengthens Staff Preparedness with Fatal Five Fundamentals Training

Executive Summary

After implementing IntellectAbility’s Fatal Five Fundamentals training program, Discovery Living Inc., an Iowa provider supporting 150 people with intellectual and developmental disabilities (IDD), achieved significant improvements in health outcomes, staff preparedness, and operational efficiency.

A one-year outcome analysis found a 37% reduction in emergency department and urgent care visits, decreasing from 254 visits in 2024 to 159 in 2025. This reduction translated into estimated annual medical cost savings of $274,410 and staffing overtime savings of $15,237. In addition, 97% of staff reported feeling better prepared to recognize preventable health risks, while 85% were able to apply their training immediately in daily practice.

These results demonstrate how proactive health surveillance training can reduce avoidable medical crises, strengthen early intervention, improve the quality of care, and support long-term financial sustainability for organizations that support people with IDD.

Background

Supporting people with intellectual and developmental disabilities (IDD) requires consistent vigilance, strong clinical awareness, and systems that empower staff to recognize risk early.

Discovery Living Inc. is committed to helping people with IDD live healthy, meaningful lives through proactive, person-centered support. To strengthen staff capacity and reduce preventable medical crises, the organization pursued training focused on the “Fatal Five” — constipation, aspiration, dehydration, seizures, and sepsis.

These five conditions are the leading preventable causes of illness and premature death among people with IDD. In fact, people with IDD are more than twice as likely to die prematurely as the general population (The Center for Inclusive Health).

By investing in targeted health surveillance education, Discovery Living aimed to move beyond reactive crisis response and toward a culture of early intervention, shared responsibility, and long-term wellness.

Funding the Initiative

This project was made possible by a $5,000 mini-grant awarded by Iowa’s University Center for Excellence in Developmental Disabilities (UCEDD). The UCEDD offered up to ten mini-grants to community agencies, healthcare organizations, community-based services, and centers to promote high-quality healthcare for people with IDD.

Discovery Living’s successful application focused on educating its employees through IntellectAbility’s Fatal Five Fundamentals eLearn program. The grant enabled all staff to access the training via IntellectAbility’s Electronic Learning Platform (eLP). The course comprises seven individual modules, along with associated resources and downloadable materials designed specifically for frontline supporters.

Implementation of Fatal Five Training

To build awareness, Discovery Living introduced the Fatal Five concepts during an all-agency training on March 27, 2024, highlighting why this training would be central to the organization’s mission moving forward. The session began with an overview of the Fatal Five presented by Dr. Craig Escudé. Staff were encouraged to actively participate, ask questions, and were informed of the expectation to complete the eLearning course.

Following the training, staff completed the Fatal Five Fundamentals eLearn course, which:

• Identifies the top five preventable causes of death in people with IDD

• Guides learners through real-world scenarios for spotting and responding to changes in health status

• Incorporates visual aids, interactive questions, and downloadable reference materials

• Emphasizes practical skills that staff can apply immediately in their daily work

What the Data Shows: Measurable Impact of Fatal Five Training

A one-year outcome analysis at Discovery Living found that Fatal Five Fundamentals training led to significant improvements in both health outcomes and operational efficiency. The training helped staff work proactively to mitigate health risks, resulting in improved outcomes for people with IDD.

After implementing the training, the organization experienced a 37% reduction in combined emergency department and urgent care visits, from 254 in 2024 to 159 in 2025. Even after excluding individuals with the highest medical utilization, visits still declined by 33%, demonstrating that the improvements were not driven by chance or population changes.

This reduction in emergency care translated into meaningful cost savings. Based on national healthcare estimates and IDD-specific utilization data, Discovery Living achieved:

• $255,210 in reduced emergency department costs
• $19,200 in urgent care savings
• $274,410 in total estimated annual medical savings

In addition, fewer emergency visits resulted in staffing efficiencies. The study estimated approximately $15,237 in annual overtime savings, along with indirect savings related to transportation, scheduling, documentation, and follow-up care. These efforts are aimed at continually improving health and wellness for the people served.

Staff Confidence and Early Intervention

Survey data from 60 staff members revealed that the training strengthened frontline clinical awareness and decision-making. The training also increased staff understanding of health risks and the importance of making decisions based on early warning signs.

After completing the course:

• 97% felt better prepared to recognize Fatal Five conditions
• 92% felt better prepared to prevent them
• 85% could apply what they learned immediately
• 83% would recommend the training
• The overall experience was rated 4.15 out of 5 stars

Staff reported increased communication with supervisors, guardians, and healthcare providers, often leading to earlier evaluations and treatment.

As one participant shared:

“Learners felt empowered to observe, make informed decisions, and act when necessary.”

The training also emphasized positive control, empowering staff to support autonomy and safety.

These changes reflect a shift from reactive crisis management to proactive health monitoring and early intervention.

Cultural and Practice Transformation

Beyond measurable outcomes, Discovery Living Inc. observed a cultural shift across the organization. Staff began discussing health concerns more openly and collaboratively, leading to earlier intervention and improved support coordination.

This approach reflects a move from traditional risk management to “replacing risk” with proactive health and wellness strategies. By focusing on prevention and person-centered support, staff are helping improve stability, engagement, and quality of life for the people they support. The organization is also promoting positive control by implementing person-centered approaches that empower people and preserve their autonomy.

Why These Results Matter for Providers

For organizations supporting people with IDD, emergency department visits carry significant clinical, operational, and emotional consequences. Each visit disrupts staffing, strains budgets, and reduces continuity of care.

This case study demonstrates that targeted health surveillance training can:

• Reduce avoidable medical emergencies
• Improve staff confidence and consistency
• Lower healthcare and staffing costs
• Strengthen collaboration with medical providers
• Improve the quality of life for people with IDD

Rather than relying on crisis response, trained teams are better equipped to identify early warning signs and intervene before emergencies occur.

About IntellectAbility’s Academy Courses

IntellectAbility’s Academy offers comprehensive healthcare and person-centered support training for providers serving people with IDD. Courses support clinical and non-clinical staff and are designed to complement organizational policies and quality initiatives.

Many courses are NADSP-accredited and offer CME or CEU credits, providing accessible, high-quality education that empowers learners to take informed action.

Each eLearn course includes:

• Illustrations
• Knowledge checks
• Real-world scenarios
• Retention-focused learning tools

Conclusion

Through UCEDD grant support and IntellectAbility’s Fatal Five Fundamentals training, Discovery Living significantly improved staff awareness, confidence, and collaboration around critical health concerns.

By strengthening early detection, communication, and preventive healthcare, the organization created a safer, more responsive environment for people with IDD. When paired with validated health risk screening tools such as the Health Risk Screening Tool (HRST®), these efforts further support early intervention and targeted support planning.

This case study demonstrates how evidence-based training can directly improve outcomes, reduce costs, and strengthen support systems for people with IDD.

Additional Resources:

• Visit our training page to explore how Fatal Five Fundamentals can benefit your organization.
• Download our free brochure to learn more about IntellectAbility’s Academy courses.
• Download the IntellectAbility and Discovery Living Inc. case study and infographic to learn more about the impact of the Fatal Five Fundamentals eLearn.