Hospitals in pursuit of excellence

Preventing Falls, Saving Lives

Preventing falls has been in the news recently, and with good reason: Among older adults, falls are the leading cause of both fatal and nonfatal injuries; in 2012, 24 million nonfatal falls among older adults were treated in EDs and more than 722,000 of these patients were hospitalized, per the CDC. The state of Minnesota ranks fifth in the nation for falls-related deaths, but those falls do not appear to have a seasonal pattern, according to the state’s department of health.  Speculation is residents tend to be less active during a Minnesota winter and may lose muscle mass, says Marsha Hughes, director, community health improvement, at HealthEast Care System.

HealthEast is partnering with the Metropolitan Area Agency on Aging (MAAA) to offer “A Matter of Balance,” an evidence-based program with several goals for participants: reduce the fear of falling, reduce falls, stay safe at home and increase exercise. The Matter of Balance program consists of eight two-hour sessions; a nominal fee is charged for the program, which is supported by grant money. Fifteen people participate in each group and do their own problem-solving in discussions led by a trained coach. The group talks about what may cause a fall and how to rethink actions. During the third session, the coach introduces exercises for 40 minutes of the class. According to Hughes, this program and other studies have validated that exercise—simple stretching exercises sitting in a chair or holding on to a chair—and strength and weight training decrease the risk of falls.

This past summer, HealthEast began coaching a group of Cambodian elders, collaborating with the Hmong American Partnership (HAP) in East St. Paul and the MAAA. Coaches worked with HAP interpreters, trusted by the group, but also adapted materials to include more photos. HealthEast now has a group of Vietnamese and Hmong participants with two interpreters. Coaches have noted similarities across all cultures—older adults may fall and not tell family members, for fear of losing independence. Since autumn 2013, nearly 150 people have participated in the program, and in 2015 it will be expanded, including modifications to target patients with Parkinson’s disease and their caregivers.
For more information, contact Marsha Hughes at mhughes@healtheast.org. 

HPOE.org offers more information and case studies about preventing falls:

• Checklists to Improve Patient Safety (HPOE guide): see checklist 5/Injuries from Falls and Immobility Top Ten Checklist
• AHA/HRET Hospital Engagement Network resources on Injuries from Falls and Immobility: change package, checklist, case studies
• Relentlessly Reducing Patient Falls
• Preventing Harm with the 6 "Ps"
• Preventing Falls with Injury: project of the Joint Commission Center for Transforming Healthcare