Oct 2021
Fall Prevention and Management
Introduction
20-30% of older adults experience a fall each year, with approximately 15% of LTC residents experiencing at least one fall in the last 30 days. These resources are designed to help providers prevent and manage falls among older adults in the primary care and long-term care settings.
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About the tool
The Centre for Effective Practice (CEP) has developed three tools to help with the prevention and management of falls among older adults.
- Fall prevention and management – for primary care providers
- Falls prevention discussion guide – for providers in long-term care homes
- Falls prevention supplement for care staff – for care staff in long-term care homes
Primary Care Tool
Fall prevention and management tool
The Fall prevention and management tool was developed using CEP’s integrated knowledge translation approach. This approach ensures that providers are engaged throughout the development processes through the application of user-centered design methodology. Clinical leadership of the resource was provided by Dr. Winyan Chung and Dr. Felicia Presenza. End users and clinical experts were also engaged to provide feedback.
The tool is one of several clinical tools developed as part of the Knowledge Translation in Primary Care Initiative. This multi-year initiative is a collaboration between the Centre for Effective Practice, Ontario College of Family Physicians (OCFP), and Nurse Practitioners’ Association of Ontario (NPAO). Funded by the Ministry of Health, this initiative supports primary care providers with the development of a series of clinical tools and health information resources. Learn more about the Knowledge Translation in Primary Care Initiative (KTinPC).
Long-Term Care Tool
Falls Prevention Discussion Guide
The Falls Prevention Discussion Guide was developed as part of the Centre for Effective Practice’s academic detailing service for LTC homes. It was designed to help providers engage in meaningful discussions with the academic detailers about assessing fall risks and managing residents in LTC to prevent falls and associated co-morbidities. As always, efforts must be made to individualize any treatment decisions for the resident, with consideration for caregivers, family and LTC staff.
The discussion guide was developed by CEP’s academic detailing service team, with clinical leadership from Dr. Sid Feldman and Dr. Andrea Moser. Health care providers and other relevant stakeholders were engaged throughout the tool development process, using a user-centred design methodology to test the usability of tools from a provider perspective. This edition was funded by the Province of Ontario as part of CEP’s Appropriate Prescribing Demonstration Project.
Supplement for Care Staff
Falls Prevention Supplement for Care Staff
The Supplement for Care Staff was developed as part of the Centre for Effective Practice’s academic detailing service for LTC homes. The content was adapted from the Falls Prevention Discussion Guide under the clinical leadership of Dr. Sid Feldman and Dr. Andrea Moser.
Clinical leads
Andrea Moser
MD, MSC, CCFP(COE), FCFP, CMD
Dr. Moser is a family physician with a focus practice in Care of the Elderly and Long Term Care, an Associate Professor, Department of Family and Community Medicine, University of Toronto and Certified Medical Director with the American Board of Post Acute and Long Term Care Medicine (ABPLM). She is the Corporate Medical Director with the City of Toronto LTC Division, Clinical Lead, LTC + program at Women’s College Hospital and consultant with ISMP Canada on the Ontario Strengthening Medication Safety in Long Term Care Program. Andrea is a board member of the Canadian Society for Long Term Care Medicine (CSLTCM) and former board member of Ontario Long Term Care Clinicians (OLTCC), formerly Ontario Long Term Care Physicians (OLTCP) and a member of the Ontario Coroners Geriatric and Long Term Care Review Committee. She is faculty for the legislated OLTCC Medical Director Course which she co-developed in 2014. Over the course of her career Andrea has worked in a variety of settings, rural and urban, and during the pandemic took on additional leadership roles to support the LTC sector. She has a commitment to high-quality person-centered care, clinician engagement, continuing professional development, collaborations and quality improvement.
Dr. Moser provided clinical leadership and was offered compensation for her role.
Sid Feldman
CFPC (COE), FCFP
Dr. Sid Feldman is a community Family Physician affiliated with the North York Family Health Team. He also serves as an attending physician in the Toronto Central LHIN Transitional Behaviour Support Unit at Baycrest for LTC residents with behavioural and psychological symptoms of dementia. His academic and administrative roles at Baycrest include Executive Medical Director of Residential Programs and Chief, Department of Family and Community Medicine. He is an Associate Professor and Head, Division of Care of the Elderly in the Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto. He also serves as the Chair, Members Interest Group in Care of the Elderly for the College of Family Physicians of Canada.
Dr. Feldman provided clinical leadership and was offered compensation for his role.
Felicia Presenza
BSC, MD, CCFP (COE)
Dr. Presenza provided clinical leadership for the benzodiazepine use in older adults topic and the fall prevention and management topic and was offered compensation for her role.
Winyan Chung
MBCHB, MRCGP, CCFP
Dr. Chung provided clinical leadership for the fall prevention and management topic and was offered compensation for her role.
Conflict of Interest
Usability participants received a token of appreciation (e.g., gift certificate).
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