How to Decrease Falls

Featured in McKnight’s Long Term Care News – Guest columns, October 31, 2018

Falls remain the leading cause of fatal and non-fatal injuries for older Americans. But by using evidence-based falls prevention programs, the number of seniors injured can be significantly reduced.

We recently decided to evaluate our Fall Prevention Program and determine what additional interventions we could implement so that we could better track the outcomes related to quality measures. We collected baseline information and reported monthly in order to track outcomes related to these efforts. The internal data indicated a reduction in total falls by 22% in communities with our Fall Prevention program, compared to baseline information from those same communities prior to initiating the program.

Recently released Centers for Medicare & Medicaid Services data confirmed those results, showing that falls with injury in these buildings were DOWN 16.0%. This compares to a nationwide INCREASE in falls with injury of 0.6%.

How did we get there? Well, we started by developing a risk list. The list includes residents that are identified as at risk for falls due to polypharmacy, history of falls, physical impairment, cognitive status, or other factors.

Using root cause analysis, the risks are systematically addressed by both nursing and therapy.

Following a course of therapy, all residents are discharged with some type of follow-up plan, i.e. restorative nursing, functional maintenance plans, home exercise programs, etc. Regular re-screens are performed so that new or unaddressed risks are quickly identified and addressed. When intervention is provided before falls occur, we are able to prevent the complications that are so often associated with falls in the elderly population.

This process can be applied to other programs in the same manner: Urinary Incontinence, Dementia, Pain, Rehospitalization, Skin Integrity, Restraint Reduction, Eating & Swallowing and more. Working collaboratively with nursing, we were able to develop a unique process for program implementation using research methods to systematically analyze and improve the delivery of clinical care.

As part of this program, we worked to develop tools to identify and track risk factors for a variety of conditions so that intervention begins before declines occur. Data is collected and analyzed in real time on risk factors, actionable steps completed by teams, and outcomes achieved.

We continue to leverage the expertise and insights of both nursing and therapy to establish evidence based practices. A proactive approach that focuses on maintaining function and preventing many of the complications and declines associated with the long term care population is essential. This unique process helps to ensure that the care we are delivering is having a positive effect on the outcomes and quality of life for our residents.

Haley Huckabee, M.A., CCC/SLP, is the director of clinical excellence at Therapy Management Corporation (TMC).