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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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Information

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 PracticeOntario 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, PhD

    Dr. Andrea Moser is a family physician with a clinical practice is in long term care and home visits for housebound frail seniors at Baycrest Health Services. She is an Assistant Professor in the Department of Family and Community Medicine, University of Toronto; Associate Medical Director, Apotex Nursing Home at Baycrest; and is a Certified Medical Director through the American Medical Directors Association. At Baycrest she is also co-chair of the Apotex Quality Subcommittee and a member of the Quality Steering Committee. She also has extensive experience in rural practice. Dr. Moser has a particular interest in dementia care and is involved with the Behavioural Supports Ontario (BSO) program through her clinical work at Baycrest on the Transitional Behavioural Support Unit and the LTC Behavioural Support Outreach Team and is the BSO primary care lead for Central LHIN. Dr. Moser is the chair of the OMA Section of Care of the Elderly and LTC, and a member of the Board of Directors of the Long Term Care Medical Directors Association of Canada.

    Dr. Moser provided clinical leadership for the development of the long-term care resources.

  • Sid Feldman

    MD, CCFP, FCFP

    Dr. Sid Feldman is a community family physician affiliated with the North York Family Health Team. He also works as attending physician in the Toronto Central LHIN Behaviour Support Unit at Baycrest for residents with behavioural symptoms of dementia. His academic and administrative roles at Baycrest include Medical Director, Home for the Aged, Executive Medical Director Residential and Aging at Home Program and Chief, Family and Community Medicine. He is an Associate Professor and Coordinator, Care of the Elderly Program in the Department of Family and Community Medicine, University of Toronto and serves as the Ontario representative on the CFPC Health Care of the Elderly Program Committee.

    Dr. Feldman provided clinical leadership for the development of the long-terms care resources.

  • Felicia Presenza

    BSC, MD, CCFP (COE)

    Dr. Felicia Presenza is a care of the elderly physician working in Sudbury, ON. She works at St. Joseph’s Continuing Care Centre on the rehab floor, and also provides dementia care at memory clinics. She has a geriatric-focused family practice and is faculty with The Review Course helping family medicine residents prepare for their CCFP exam.

    Dr. Presenza provided clinical leadership for the development of the primary care fall prevention and management tool and detailing topic.

  • Winyan Chung

    MBCHB, MRCGP, CCFP

    Dr. Winyan Chung is a family physician in Sault Ste. Marie ON, working in primary care, long term care and hospital in-patient service. She is currently working as clinical co-lead for the Healthy Aging Project with the Algoma Ontario Health Team.

    Dr. Chung provided clinical leadership for the development of the primary care fall prevention and management tool and detailing topic.

Clinical working group

The following clinical working group of providers helped with the development of the primary care tool:

  • Elizabeth Allen, BSc, MD, CCFP
  • Jennifer Brooks, BSc, MD, CCFP
  • Dana Corsi, MScHQ, BScOT, OT Reg. (Ont.)
  • Connie Davis, MN, RN, GNP, BC (retired status)
  • Sarah Doyle, MD, CCFP
  • Cassandra McCarthy (Caregiver)
  • Rebecca McEwen, RN(EC), MSc
  • Kelly McIntyre-Muddle, MSc, OT Reg. (Ont.)
  • Brenda Murray (Caregiver)
  • Jobin Varughese, MD, CCFP (COE), CMD

Conflict of interest

Clinical leads received compensation for their role. 

Clinical working group members received an honorarium for their participation. 

Usability participants received a small token of appreciation (e.g. gift certificate).

Thank you

Thank you to everyone who supported the development of these tools and resources!


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