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CME Certified Fall Prevention module
In a cross Canada review, there were few certified Fall Prevention programs targeted towards Primary Care physicians and their healthcare professional teams. Dr. Frank Molnar, Geriatrician, and his team have changed that! The Champlain Fall Prevention Steering Committee, Dr. Molnar and the Regional Geriatric Program of Eastern Ontario have worked together to deliver an interactive Fall Prevention module which utilizes the Champlain Fall Prevention tools. This online group learning program meets the certification criteria of the College of Family Physicians of Canada and has been certified by the University of Ottawa’s Office of Continuing Professional Development for up to 2 MainPro+ credits.
The sequential modules focus on education, client self-screening using the Staying Independent Checklist, and delivery of the appropriate and evidence-based follow up assessment and diagnosis to determine the root cause of the fall. Selecting the right intervention and referral is also covered in the module.
A complement to this CME program includes access for non-registered health care workers to an online PSW Fall Prevention module. It can be useful for volunteers, receptionists and other non-registered team members as it provides information to enable them to act as a coach and guide for their older clients and to understand the importance of self-screening and the use of the Staying Independent Checklist as part of the Champlain Fall Prevention Algorithm.
These two modules are components of the Fall Prevention education framework to reinforce the delivery of the best practices in Fall Prevention across the continuum. Work is now being undertaken to provide other registered healthcare professionals with similar support,
All of these resources and the link to sign up for the CME module can be found through the www.stopfalls.ca website
Falls Prevention Planning in Champlain: Article 6 – Exercise Class Navigation Flow Chart: Evaluation
As described in our last article physical activity plays a very important role in Fall Prevention but it has often been complicated in the past, for seniors to find the class with the right fit for them to enable them to continue to participate. The purpose of developing the exercise class navigation tool was to make it easier for seniors to access LHIN funded exercise classes across the region. The Champlainhealthline.ca link “Exercise Classes for Seniors” shows the “Which Exercise Class is Best for Me” flowchart and a list of the available classes in the senior’s locality.
The chart was launched nine months ago for Fall prevention month in November 2016 and the time has come to ask users what they think of it, and to understand whether it has achieved its purpose and what improvements can be made.
To do this a questionnaire has been developed and will be visible when seniors, family members, and caregivers as well as referrers use the Champlain Healthline at www.champlainhealthline.ca
We would like to ask you as referrers and health care providers to give us your feedback as well as encouraging your patients and clients to complete the very short survey which can also be found here.
Thank you for your time and your help in making sure that the navigation chart is relevant and useful for seniors and their care providers alike.
Falls are a leading cause of injury among seniors. 20-30% of seniors (age 65+) experience one or more falls each year and 85% of seniors’ injury-related hospitalizations are due to falls.
The Champlain LHIN IMPACTT Centre is conducting a research project supported with Ontario Centres of Excellence funding from the MOHLTC Ontario Chief Innovation Strategist.
This project will ddetermine the value of a falls prediction model that leverages a new technology; QTUGTM and uses trained technicians (non-professionals such as personal support workers) to engage seniors that are normally not being actively screened for falls, and to identify those at higher risk of falling prior to their first fall.
If a senior has been identified with a moderate to very high falls risk, we are suggesting they take the handout materials and speak with their physician or other healthcare professionals to better understand what may be contributing to their risk of falls and what they can do to help prevent falls.
What is QTUGTM?
The “Timed Up and Go” or TUG test is one tool that health professionals use during a falls assessment. It consists of the person getting up from a chair walking 3 meters, turning around, walking back the 3 meters and sitting down while the professional monitors the time it takes, the gait, steadiness, etc.
The QTUGTM uses sensors worn on the shins (over clothing) and a hand-held tablet to track the person during the TUG test. With proven qualitative input, analytical data and algorithms it produces a Falls Risk Score.
First, the person is asked a few questions about age, weight, height, recent falls, any problems with mobility, medications, blood pressure, dizziness and/or vision. The sensors and tablet then measure the time taken to stand, average stride time, average stride velocity, step time variability, time taken to turn, number of steps in turn and time to complete the test. The sensor information combined with the short falls questionnaire determines your risk of falling.
For more information contact the IMPACTT Centre.
Email: Judy Marshall-Brunke
Tel: 613-745-8124, ext. 5879 | Toll Free: 1.800-538-0520
Exercise Class Navigation Flow Chart
Encouraging seniors to exercise and to be physically active is an important part of a fall prevention strategy. Exercise programs that promote balance training combined with strength and flexibility have been shown to be effective in significantly reducing falls and the injuries resulting from a fall. LHIN funded exercise and Fall Prevention programs are available across the Champlain region, and different levels of programs for people of different abilities are provided. However, determining which class is the right one is key to ensuring that participants gain maximum benefit from the class. Choosing the wrong level of class can be a lost opportunity to promote increased activity.
To simplify the choices and decisions for older adults, their families and health care providers, the Navigation Working Group of Champlain Fall Prevention Steering Committee has developed a flow chart. Each region has its own flow chart with local class details and contact information, but the descriptions for each level have been standardized across Champlain with consistent wording for each level of class.
List of locations (Renfrew County and District)
On the reverse of the chart is the Staying Independent Checklist and seniors are urged to complete this fall-risk screening tool, although it is not a determinant of exercise and activity levels. This screen is a key first step in the Champlain Fall Prevention Algorithm of Detection, Diagnosis and Intervention. Primary care providers should encourage their older patients to complete the Staying Independent Checklist annually and to bring issues and concerns to the primary care team.
The exercise class flow chart will be launched in November 2016 (Fall Prevention month) and will be distributed to public health units, community support services, primary care providers and other agencies, to encourage seniors to choose an active lifestyle. The flow charts can be found on the www.stopfalls.ca website under the community resources tab, and also on the Champlainhealthline website , under the Exercise Classes for Seniors button, “Which Exercise Class for me?”
For more information contact:
Champlain Falls Prevention Strategy
Regional Geriatric Program of Eastern Ontario
Cell Phone 519 639 3000
Yes, according to this article which describes the effectiveness of a 2 year balance training program to prevent fall induced injuries in women at risk for falls.
This is one of the first randomized control trials to show a decrease in injuries from falls with an intensive exercise program. The participants also had a better perception of their overall physical health than the control group.
Exercise and Falls Prevention in Champlain
Fortunately there are exercise and fall prevention programs available in our region. For Ottawa residents, take a look at the Better Strength, Better Balance program with sessions starting in September.
Information on other exercise and falls prevention classes in the region is available on Champlainhealthline.ca.
Finally, your patients may be interested in these fun falls prevention videos from Ottawa Public Health.
Falls have a significant impact on individuals, families, society, and health care systems. Find out about what’s being done provincially and locally to prevent falls among the older adult population.
- 1 in 3 seniors fall every year
- Half of seniors who fall do so repeatedly
- 1 in 4 falls result in injuries including sprains, fractures, and death
- Falls are the leading contributor to overall injury costs in Canada and account for $6.2 billion or 31 per cent of total costs of all injuries (Smartrisk, 2009)
- Falls cause more than 90 per cent of all hip fractures in the elderly and 20 per cent of seniors who suffer a hip fracture die within a year
- A single hip fracture adds between $24,600 to $28,000 in direct health costs to the system. Almost half of people who sustain a hip fracture never recover fully
- The mean length of stay for a falls-related injury is approximately 15 days (Scott, Wagar & Elliott, 2010)
- In the Champlain region this is can be translated as:
- 2,765 admissions of seniors from Emergency Department for falls in 2013
- The equivalent of 41,475 bed days at a cost of $17.2 million
- Average length of stay for a falls-related admission = 15 days
- Cost per bed / day = $415 (50th percentile)
- Falls are directly accountable for 40 per cent of all elderly admissions to nursing homes or long-term care facilities
What is being done to prevent falls?
Many jurisdictions internationally have developed approaches to reduce the number of falls and research tells us that a reduction of between 6% and 33% of fall-related injuries can be achieved through coordinated, community-wide, multi-strategy fall prevention initiatives (McClure et al., 2005).
In Ontario a task force was convened and developed the Provincial Integrated Falls Prevention Framework and Tool kit which was introduced in 2011.
In 2012 the Champlain LHIN began to invest in the development of a regional Falls Prevention Strategy. This initiative is a partnership between the LHIN, the region’s four Public Health Units, the Regional Geriatric Program of Eastern Ontario (RGPEO), and primary and community health care providers. Primary Care and Public Health leaders co-chair the Champlain Falls Prevention Steering Committee, which draws membership from across all health care sectors.
The objective of the strategy is: To effectively reduce falls and the impact of falls on Champlain older adults through a coordinated, evidence-informed approach to falls prevention that builds on community-wide, inter-sectoral collaboration.
The feedback from an early 2013 survey of primary and community care providers made it clear that a standardized approach was wanted and required to support teams in these sectors to provide screening, assessment, and intervention in order to prevent falls in their senior populations. Coordination, use of standardized tools and communication, and access to up-to-date resources that are relevant and useful were all issues that were raised in the survey.
Next month’s article: Responding to the issues: What have we done so far?