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A System Change Approach to Falls Prevention in Champlain

In this second article about the Champlain Falls Prevention Strategy, we look at what’s been done so far to respond to regional issues around falls prevention.

Responding to feedback from a survey held in early 2013, the Champlain Falls Prevention Steering Committee identified the establishment of a suitable Falls Prevention pathway and process for use across the region as a priority. Focusing on the primary and community care sectors, this systemic approach would support practitioners in the management of falls prevention in their daily practice.

Throughout 2013, the Steering Committee developed a strategic framework of six foundational pillars to guide the work required to bring about a system change in the way that Falls Prevention is managed regionally across all care sectors.

The six pillars are:

  • Public Awareness and Engagement
  • Detection, Diagnosis and Intervention
  • Best Practices for Health Care Professionals
  • System Navigation
  • Performance Management
  • Advocacy

With funding support from the Champlain LHIN, a clinical working group composed of Community and Primary Care practitioners met in the summer of 2013. Based on current evidence the working group determined that it was imperative to have a tool that would provide screening, assessment and intervention capabilities, and which could assist clinicians and health care providers in identifying and ameliorating fall risk. It also had to be viable in a variety of settings.

The development of standardized screening tools which could be widely used in the community was seen as a valuable component in building consistency throughout the region. Following a literature review the working group identified a model that would be practical and relevant, evidence-based and would promote and support the use of standardized assessment tools. The American Geriatric Society/ British Geriatric Society algorithm was the best match but required some adjustments to make it suitable for local needs. The pathway included the Staying Independent Checklist / Demeurer autonome as a screening tool that could be used by older adults with their families, caregivers or health care providers.

By December 2013 the algorithm and checklist were ready to be tested in the field. Seaway Valley CHC, Pinecrest Queensway CHC (Nepean site), Dr. Helen O’Connor at the Montfort Academic FHT and Dr. Charles Adamson in South Mountain provided invaluable feedback during the trail period when they used the Falls Prevention tools with a total of 108 older adults.

A community information sharing session was held for Renfrew County, and North Lanark, Leeds and Grenville practitioners. A thorough evaluation of the trial took place and informed the refinement and finalization of the algorithm which was completed in the fall of 2014. The documents were translated into French and resources were loaded onto the and the Regional Geriatric Program of Eastern Ontario (RGPEO) websites. The website domains and were linked to the website for ease of access. Work is now being done with the Primary Care Network subgroup, Practice Solutions, to include the algorithm in the EMR.

The Champlain Falls Prevention Algorithm and Staying Independent Checklist are available on the Falls Prevention page.

Article written by: Jane Adams ( and Christine Bidmead (, Project Managers, Champlain Falls Prevention Strategy

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