East Region EMS and Trauma Care Council

East Region Injury Prevention Focus Area

A Report on Falls Prevention in the East Region - January 2013

The falls prevention program of the East Region EMS & Trauma Council is founded in  evidence-based recommendations as noted  by the Centers for Disease Control (CDC) and the WA State Injury and Violence Prevention Guide.  Falls are the leading cause of hospitalizations and death due to injuries among East Region EMS residents. The average cost per Emergency Department visit in a Spokane hospital was $5,998 in 2011.^[1]  In a national study, on average, the hospitalization cost for a fall injury was $17,500.^[2] This does not count the rehabilitation costs, skilled nursing facility costs, and other long-term care costs.

Counties are prioritized for intervention within the East Region by reviewing current rates of hospitalizations and deaths by falls and identifying key stakeholders in each community to assess for readiness.  Table A contains the current hospitalization and death rates for East Region. Rates are based on 100,000 population size. [3]

*indicates areas of focus

Recommended Strategies

(Source: WA State Department of Health Injury and Violence Prevention Guide)

Evidence-based (best practice)

• Falls risk assessment and management program is most effective.  The next most effective is a strength and balance exercise program.  A variety of providers have successfully intervened to prevent falls, including: exercise instructors, nurses, physical therapists, social workers, teams of multiple providers
• Increase multi-factorial fall risk assessment and management programs that include individually tailored follow-up interventions for older adults at high risk for falls
• Increase the availability of low cost, accessible exercise programs tailored for older adults that include strength, balance, and mobility exercises.
  • Provide education to older adults on risk factors for falls and fall prevention strategies, in combination with exercise programs and assessments.
  • Conduct professional education on fall risk factor assessment and interventions for physicians and other health care providers. 
  • Develop a community infrastructure to help implement comprehensive fall prevention programs. 
  • Community partnerships should designate specific agencies to provide on-going leadership to implement the listed strategies.  Essential components include: programs for individuals who are at especially high risk of falling; programs for older adults at lower risk, to keep them active, independent and in the low-risk falls free category.

Components of falls prevention program:

• Promote and educate on the use of “My Falls Free Plan” and other appropriate tools such as the CDC Stop Elderly Accidents, Death, and Injuries (STEADI) tools in East Region hospitals, with Physical Therapists, and Primary Care settings. Encourage and assist with policy development regarding these tools.
• Support Stay Active and Independent for Life (SAIL) exercise class instructors in the rural counties. Provide additional exercise instructor trainings as needed/requested. Help with marketing for community-based SAIL classes.
• Coordinate efforts with Fall Free Spokane Coalition, a Spokane County focused collaborative partnership with some regional overlap. Assist with networking and reproduction of activities throughout region.  Provide technical assistance to rural counties to start Fall Prevention Coalitions and/or collaborative partnerships as appropriate/desired
• Through collaborative partnerships, conduct education classes targeted to older adults 65+ through community based venues such as retirement communities, churches and exercise classes. Class curriculum is evidence-based material authored by fall prevention researcher, Dr. Dorothy Baker.  EREMS provides “Aging Safely” booklet to accompany presentations.
• Through collaborative partnerships, conduct fall risk assessments for older adults at Celebrate Life Conference annually, and other appropriate venues as identified.  EREMS and SRHD provide SAIL guides from DOH and tools for providers to make recommendations for follow up with a physician or other health care provider if needed.
• Represent EREMS to the WA State Falls Prevention Coalition.

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[1] INHS, Meditech Sytem per SRHD, CHAPE, 01/15/2013.