Keeping Older Adults Active, Independent and Safe from Falls – Community Gap AnalysisKey strategies for preventing falls across settings
Fall Risk Screening
1a) A person(s) is assigned to coordinate the fall risk screening and referral implementation process.
1b) Point people are identified from the appropriate setting(s) to champion the implementation effort.
A fall risk screening process is in place to screen for fall and injury risks in older adult patients. The fall screening addresses:
- Has the patient fallen recently? (i.e., last 12 months)
- Is the patient afraid of falling?
- Is there any mobility/balance/gait issues? (patient observation)
- Patient age (>85)
- Bone issues (e.g., osteoporosis)
- Coagulation (anti-thrombotics)
1d) Home Care
1e) Assisted Living
1f) Outpatient Hospital
1g) Inpatient Hospital (will have a more comprehensive screening process)
1h) Nursing Home (will have a more comprehensive screening process)
1i) Safety precautions are in place within the fall screening environment for older adults identified at risk for falling or being seriously injured if they fall. Examples of safety precautions include:
- Direct visualization of at-risk individuals (e.g., leave exam room door open during wait times)
- Assistance/monitoring during toileting
- Patient rounding
- Provide mobility assistance/mobility aids as appropriate
- Access to call for assistance if needed
- Orientation to surroundings
- Safe Environment (e.g., no sharp edges, minimize clutter, adequate lighting)
2a) Processes are in place to refer at risk patients to a provider, as appropriate, for further assessment to manage underlying conditions/contributing factors.
Referrals for Community Education/Services
3a) The community has evidence-based programs available in the community for older adults for improvement of gait, strength, and balance.
A process is in place to refer older adults to community programming to improve knowledge, gait, strength, and balance, including:
3b) Referral from clinic to community programs
3c) Referral from hospital to community programs
3d) Referral from home care to community programs
3e) Referral from assisted living to community programs or to internal evidence-based programs.
Processes are in place to refer older adults to other services as appropriate including:
3f) Medication Review
3g) Home Safety Review
3h) Therapy, as appropriate
3i) The community has transportation support in place to enable older adults to participate in community programs.
4a) Community partners have completed an assessment to determine readiness for a fall prevention coalition/ partnership in the community.
4b) Community partners have determined the lead organization (s) for the coalition/ partnership.
4c) Community partners have identified and recruited coalition/ partnership members from across the community.
4d) A coalition/ partnership is in place to develop and oversee the strategic plan for addressing fall prevention in the community.
4e) The strategic plan, which includes a written sustainability plan to ensure long-term viability, has been reviewed by the coalition/ partnership and is updated throughout the year.
Coalition members from across the community are involved in implementing the strategic plan, including representation from the following at a minimum:
4h) Nursing home (care centers)
4i) Assisted Living
4j) Home Care
4k) Area Agencies on Aging (AAA)
4l) Emergency Services (i.e., fire department; EMTs)
4m) Public Health
4n) Community Education
The coalition/partnership has a process in place to track progress including at a minimum:
4o) # of falls within the community
4p) # of older adult community members participating in community programming related to fall prevention.
4q) The coalition/partnership has a process in place to share data with partners and with the community.
4r) The coalition/partnership has developed and implemented a communication strategy to promote participation in community falls efforts.
Collaboration between hospitals and long-term care
5a) A process is in place to communicate key fall risk and injury risk information between hospitals and nursing homes.
5b) A process is in place to communicate key fall risk and injury risk information between nursing homes and hospitals.
5c) Hospitals and nursing homes within the community meet on a regular basis (at least annually) to discuss barriers and strategies for falls prevention.