NH Falls Task Force

Meeting minutes

6/6/17

Present: Keliane Totten, Beth Slepian, Linda Cook, Sharil Cass, Judy Cote, Debra Samaha, Dawna Pidgeon, Cathy Mullen, Renee Noelle, Maria Boren, Mary Catherine Rawls, Karen Anderson

CHI contract no longer funded. Debra S has all information from Debbie Love and will follow up with Tim
Linda Johnson contacted us about linking to their web site-Deb will get back- Task Force not willing to link to for profit sites.
Dawna reviewed Christine McDonough’s study published in the journal Physical Therapy: Falling Down on the Job: Evaluation and Treatment of Fall Risk Among Older Adults with Upper Extremity Fragility Fractures
From Medicare Claims data: Between 10.7% to 18.5% diagnosed with proximal humerus or wrist fractures (65+ year old) received PT evaluation up to 6 months after injury
Risk of decline after UE fracture and low screening/treatment- important opportunity at a time when intervention helpful
People with recent fractures are at high risk for future fall injury- should trigger a minimum of assessment of fall risk if not referral
Timely multifactorial intervention could have significant impact on future falls/fractures- this group may be more likely than hip fracture- more mobile- to have benefit (50 hours balance ex- 42% reduction-Sherrington)

Conference- Theme: High Risk Populations
Debra Fournier, APRN- TBI-Confirmed- will make sure she targets all levels- including concussion
Tufts- Frailty- LIFE study - Lora will contact them
Christine McDonough- UE fracture – Dawna will ask
Dementia- cognitive impairment-? Rita Moscola – VA in Manchester- Karen will follow up
Mary Catherine- Confirms she can speak re: Inpatient: D-H Safety Champion- for inpatient- developed to incorporate falls- NICHE (Nurses Improving Care for Healthsystem Elders- program to improved care for elders- moving into long-term care- been around for 20+ years), nurses and LNAs at bedside part of program- Gerontology resource nurses- had a good run of fall, dropped off; 8 healthsystems in NH involved with NICHE- DHMC since March, Elliot, Franklin, LRH, Exeter, Portsmouth, Parkland, CMC; ~ $5000/year- may depend somewhat on size. In process of revamping program- associated with NYU and Hartford Institute. Also programs for Dementia, delirium
Will put up program maps
Posters- will need to send out a call for posters soon
? Vendor groups wanting table at – will ask Lora if we can charge (we could target these funds for database fee after Dartmouth grant ends)
Dawna to ask Lora – how she wants speaker connection
Placemats
Falls Awareness Month- last year Mary MacCaffrie provided placements – September for Falls, October for Fire. Deb is also involved with CO project. 10,000 were distributed statewide through St. Josephs- Brooke. Deb- surveyed sites- felt there was valuable. Also interested in CO for November. Senior Centers, Meals on wheels, congregate meals sites. Also brought to conference for attendees to have. Waiting to hear back from Mary.

Data- Funding- Grants
UNH Survey Center- asked question about Senior Citizens Falls- just completed survey in May. Deb has report. Started in 2012. Repeated in 2015 and May 2017. Improved in “Do you think injuries related to falls are preventable?” Improved from 30% to 37% say “yes”. “Do you think such injuries are a normal part of aging?” July 2012 went from 58% to 50%. Survey is all ages. Random telephone. Compared 2012 to 2017. Looked at regions as well- CT Valley area had highest % of preventable. North Country 2nd highest.
Next week have IPAC meeting- state injury report- part of that is falls. Cathy is working on updating data for report. Deb showed maps we have used in the past-including sharing with legislators.
Maps are from WISDOM database and from JoAnne. Cathy could present at a Quarterly meeting. We can get up to 2014 data. All agreed updated maps would be helpful. Should think about vision impairments when putting in colors.
Last year we did a “NCOA Fact Sheet” – will look into getting this up on the website
Discussed Data entry- state uses data- Dartmouth will not continue to fund or enter data after this grant period ($250/year) - Deb, JoAnne and Cathy will meet to discuss ongoing support. State wants to know how many programs, how many participants- data can give us more information. Dawna to check- what is the time commitment for data entry.
? is there a way to look at falls reduction data in areas that have programs
Deb- a bit difficult- could look at that over time moving forward
Program Maps
Distributed
Were done in Adobe Photoshop- will follow up with Tim- ? have this software to update moving forward for website
? lighter shades to show the reach of the region
Disclaimer- please call for price and range availability

? Video-never happened – no statewide push for healthcare providers yet- ? Work on this next year. Keliane- Better Choices- Better Health- evidence shows better with patient self referral
Maybe talk about how to move forward with Hub/registry type program without funding
? look to toward insurers
Legislators- want NH Data
1115 Waiver- 7 integrated Delivery systems in NH- mental health- Beth Slepian- Dartmouth

Quarterly
November - John Wilcox and Matt Petrin
Keliane will contact Tim Hesselton to post her presentation
? Cathy Mullen for May 2018- WISDOM DB

Team members updates
Judy- Lee Silverman BIG Program going well- 3 waiting list. Judy will be retiring in October. She had kind words for the committee. Deb- we all appreciate all Judy’s work over the years.
Cathleen- years 2012-2014 for UE fracture- doing for Dawna. Opioid crisis taking a lot of time- seniors as well
Ria- Alida had a boy- Joseph-doing well- due back at the end of July. Just completed Merrimack MOB- sent in data. Trying to connect with Linda in Peterborough for collaboration. Will look to expand to another town when Alida is back.
Mary Catherine- yesterday went to state committee on Aging meeting- 4 hour program at Colby Sawyer college this morning- MOB one of the topics, Jill Bert- from Bureau of Alcohol- increasing incidence of elders and substance abuse as well as suicide rate. 20% of psych admissions for elderly related to alcohol or drug abuse. NH Budget- one of board members a rep from Stoddard. Back to house. New MC program in charge of programs in NH. Next state committee on aging meeting- July 10th- usually first Monday of the month. Will send out state gerontology conference flyer when available- pharmacology and the elderly.
Karen Anderson- at VA- 36 subacute beds- teaching modified TJQMBB by Laura Shannon. Julia Neily- WRJ- national VA Falls initiative. Manchester starting to integrate more. WRJ is developing CLC-community Living Center- Palliative and long term care. Internal falls committee- new leadership. Leaving June 30th. Hope to rejoin committee in September. She is also a certified case manager. Interested in mindfulness in Dementia.
Renee Noelle- Arete Rehab- contract rehab providers. Competing with i.e. Genesis, Kindred. Started new division called Rehab 365- Amesbury MA clinic. Opening a second clinic in Salem. Outpatient services billing. Provide care in community. Focused on fall prevention and senior health and wellness. Trying to improve coordination. Piloting a program to decrease readmissions- after meds, lack of communication #1 reason back in hospital.
Keliane- hoping to get a grant from Aging Mastery Program
Linda- just finished 2 programs of MOB-one at Bond Wellness Center and one at KSC. Bond- coaches enthusiastic about partnering with MOB. Change in leadership at KSC.
Sharil Cass- now has BIG program certified therapist. Sharil- email- ? Changing password to for WordPress.

Next meeting change to 7/11- conference planning firm up speaker information, etc. Offer a call in option. Want to hold in Lebanon and have phone in. Cathy will reserve a room here for August 4th.