Nova Scotia Falls
Prevention Initiatives
OIPRC IP Forum
March 3, 2010
Suzanne Baker
The leading causes of falls
are preventable…
with a coordinated
prevention effort.
Seniors’ Falls Facts
Falls: the most common cause of injury for
seniors
• 3,317 hospitalizations
• 61% are females
• 54% of injury-related hospitalizations
Seniors' Falls
in Nova Scotia
District Reports
http://www.gov.ns.ca/hpp/publications/seniors_falls.pdf
Injury Related Hospitalizations
Injury Related Deaths
Annual fall-related hospitalization rates by
age and gender, 2000–2004
Number of FRHs per 1,000 population
Female
Male
70
60
50
40
30
20
10
0
65–69
70–74
75–79
Age group (years)
80–84
≥85
Annual fall-related death rate by
age and gender, 2000–2004
Number of FRDs per 10,000 population
Female
Male
50
40
30
20
10
0
65–69
70–74
75–79
Age group (years)
80–84
≥85
Fall related hospital days
Anatomic site of injury for falls requiring
hospitalization, 2001–2004
70–74
65–69
75–79
80–84
≥85
Percentage of FRHs
60%
45%
30%
15%
0%
Head or
Neck
Trunk
Upper
Limb
Hip
Fracture
Other Lower
Limb
Anatomic site affected by fall injury
Multiple or
Unspecified
Hospital Costs for Selected Fall-related Injuries
Among Seniors, B.C., 2001/2002 to 2004/2005
Fall Injury
Average Hospital Cost
per case
Average Annual
Hospital Cost for all
Cases
Hip fracture
$18,508
$75,253,165
Upper limb injuries
$11,571
$14,107,527
Head Injuries
$14,425
$14,821,189
Abdomen, lower back,
lumbar spine, and pelvis
injuries
$14,135
$13,883,954
Economic Burden Reports
The Economic Burden
of Injury in Canada,
1998
The Economic Burden
of Unintentional Injury in
Canada,
2004
Mortality Rates Due to Falls, 2004
New Brunswick
9.2
Newfoundland and Labrador
3.4
Nova Scotia
Prince Edward Island
CANADA
12.6
9.4
7
Fall Injuries:
the Surface
Deaths
Hospitalizations
Emergency Dept
visits
Treated in a
physician’s office
Treated at home or
never treated
15
Scope of the Issue
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By 2016
Anticipated fall related injuries
Fill a 523-bed hospital
Every bed
Every day
Department of Health
• Department of Health - Falls Risk Assessment
Framework
• Designed to raise the awareness of falls and falls
prevention
• Provide necessary information
• Create individualized, practical falls assessment tools
and programs
• Relevance in home care, acute care, and long-term care
settings
• Used to build on existing falls prevention programs or to
assist in developing new falls prevention programs.
• http://www.gov.ns.ca/hpp/publications/FallsFramework.p
df
Purpose of Strategic Framework
• Get everyone focused
• Establish a collaborative plan for:
– policy makers and government
– DHAs, continuing care sector
– communities
– professionals
• Maximize collective ability to address
seniors falls
Overview of Document
• Consequences of Seniors’ Falls
– Human impact, costs, and Nova Scotia data
highlights
• Causes of Seniors Falls – Risk Factors
– Biological and Medical Risk Factors
– Behavioural Risk Factors
– Environmental Risk Factors
– Socio-economic Factors
Overview of Document
• Best Practice Approaches to Falls
Prevention
• Strategic Framework Background
– Purpose
– Process
– Strategic Alignments
Guiding Principles
1.
2.
3.
4.
5.
6.
7.
8.
9.
Living, evolving document
Focused on risk factors
Strategies reflect community, cultural differences
Evidence-based, comprehensive
Relevant to needs, grounded in data and research
Foster collaboration
Support and build on existing efforts
Population health approach
Be adequately resourced
Strong Foundation Exists
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Provincial Intersectoral Falls Prevention Committee
Data Report
Community Links – Preventing Falls Together
Department of Health - Vitamin D and Falls Assessment
Framework)
Department of Seniors – Strategy for Positive Aging
District Leadership – South Shore Health
Falls Prevention Conference
Health Canada, Veterans Affairs, and Public Health
Agency of Canada
Strategic Goals
1.
2.
3.
4.
5.
Leadership, Infrastructure, and Partnership
Awareness and Understanding
Education
Supportive Environments
Knowledge Development and Transfer
1. Leadership, Infrastructure &
Partnership
GOAL: Appropriate and adequate
leadership, infrastructure, and
partnerships sustain all aspects of the
Strategic Framework.
Leadership Activities
• Providing ongoing leadership and support at
provincial and DHA levels
• Provincial Intersectoral Falls Prevention
Committee
• Coordination funding
• National Collaborative on Falls in Long-Term
Care
• Funding Preventing Falls Together
• Canadian Falls Prevention Curriculum Delivery
Safer Healthcare NOW!
National Collaborative on Falls Prevention
• Three DHA
• Annapolis Valley Health
• South Shore Health
• South West Health
• Acute Care sites
• Alternative Level of Care units (# of beds)
• Promoting collaboration between DHA’s
while enhancing Patient Safety and
Quality of Life
Home Support Exercise Program
(HSEP)
• The Home Support Exercise
Program (HSEP) was
developed for the frail elderly
living in the community.
• It is comprised of 10 simple,
yet progressive exercises
designed to enable older
adults to enhance and/or
maintain their functional
mobility and independence.
Home Support Exercise Program
(HSEP)
• Evidence-based physical activity
intervention for frail elderly
• Canadian Centre for Activity and Aging
(UWO)
• Designed for home support workers
• Capital Health and GASHA
Provincial Intersectoral Falls
Prevention Committee
• Purpose: To guide and monitor the
implementation of the seniors’ falls
prevention strategic framework
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Philosophy
Responsibilities
Composition
Highlights
2. Awareness and Understanding
GOAL: Nova Scotians are aware of the
issue of seniors’ falls and fall-related
injuries and understand how to prevent
them.
Activities
• Social marketing workshops to Falls
Prevention Coalitions and other partners
• Support for annual falls prevention week
• Ongoing education and meetings with
policy makers
A Population Health
Approach to
Fall Prevention in NS
Community Links
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Provincial, non-profit charity
Seniors issues
Member of the Group of IX
Age Friendly Communities
Community Development
Volunteerism
Members are seniors and senior serving
organizations
Preventing Falls Together
Goal
Reducing falls and fall related injuries
by seniors in NS using a population health
approach at regional coalitions
Preventing Falls Together
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Population Health Approach
Age Friendly Communities
Regional Coalitions
Tool Kit & Checklists
Regional Coalition Projects
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Senior Parking Spots
Grit Bags
Safe Public Spaces
Walk Abouts
Physical Activity
Conference
Municipal Election
Regional Coalition Projects
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Places of Worship
Hair Salons & Barber Shops
Presentations/workshops
Nightlight Partnership
Recreation Facilities
Falls Prevention Week
Susan King – Provincial Coordinator
Email: coordinator@preventingfallstogether.ca
Telephone: (902) 539-6098
www.preventingfallstogether.ca
Falls Prevention Week
November 23-27, 2009
Proclamations—towns and district health authorities
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Foot Care Information Session - Digby
Articles on Falls in Newsletters and papers in Western NS
Don't Fall For Christmas gift list
Posters enlarged and distributed throughout Western NS
Displays in hospitals, Red Cross Office and NQ Health Center
Placemats
Taglines on emails Digby and Area CHB
Places of Worship Project in Lunenburg and parts of Queens
Falls Prevention Talks
Falls Prevention Clinic
3. Education
GOAL: Seniors, care providers,
organizations, and communities have
the skills and knowledge to reduce the
risk of falls and fall-related injuries.
Activities
• Canadian Falls Prevention Curriculum delivery
and leadership (By the end of January more
than 300 people will be certified in the CFPC)
• Support for Tri-District project
• Funding for Red Cross H.E.L.P. program to
incorporate falls prevention within their initiative
• Preventing Falls Together Toolkit
• Falls Prevention Conferences
Canadian Falls Prevention
Curriculum
• February 2008
• Participants will learn about:
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nature and scope of seniors’ falls
complex causes of falls
modifiable risk factors
Identification of seniors at increased risk of falling
evidence-based risk assessment tools
best practice interventions
applying a practical program planning model to the design
implementation initiatives
evaluating the effectiveness of programs
4. Supportive Environments &
Policy
GOAL: Supportive environments are
created and nurtured by healthy public
policies that promote health and reduce
the risk of falls and fall-related injuries.
Activities
• Canadian Falls Prevention Curriculum
delivery and leadership
• Funding for part-time position to facilitate
coordination among districts
• Provide expert advice to province and
DHAs Strategy for Positive Aging
Provincial Falls Prevention District
Network
Purpose:
A forum for the DHA and IWK to collaborate
on data collection…
Scope:
The focus of the network will be on the acute
care/hospital setting.
Strategy #1
• Establish a network of DHA leaders and
staff
• Facilitate greater collaboration and sharing
of falls prevention information
• Tools, policies and programs
• Scope of the network includes the
continuum of care
Strategy #2
• Web-based central forum for the exchange
Strategy #3
• Develop and recommend standardized
evidence based policies
• Data collection processes
• Risk assessment
• Intervention tools for the DHA
Strategy #4
• Guidelines for evaluating existing and
future tools, interventions, and policies.
Accreditation: New Required
Organizational Practices for 2008
• New Goal—Reduce the risk of injuries resulting
from client falls
• New ROP—implement and evaluate a falls
prevention strategy to minimize the impact of
client falls
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Falls prevention strategy
Population at risk for falls
Specific needs
Evaluation
Improvements
5. Knowledge Development &
Exchange
GOAL: Community action and the
decisions of policy makers are
informed by timely collection, analysis,
and dissemination of data and research
on seniors’ falls.
Activities
• Funding for Dalhousie University and South Shore
Health falls research partnership
• National initiative involvement to improve collection and
dissemination of seniors’ fall-related data
• Collaborator on CIHR Grant Proposal – Canadian
Longitudinal Study on Aging (CLSA)-Injury Team (IT)
initiative
• Continue to share and promote the Seniors’ Falls Data
Report
• Canadian Falls Prevention Curriculum Delivery and
Leadership
Research Initiative
• Partnership between South Shore Health and
Dalhousie University, funded by Health
Promotion and Protection
• Addresses the effectiveness of processes used
in a rural District Health Authority to develop and
implement a complex health initiative, namely
Seniors Falls Prevention.
• In the third phase of research, analyzing the
data gathered from 3 teams taking action on
falls.
Early Emerging Themes
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Complexity
Non-linear relationship
Barriers and supports
Next Steps
• Establish seniors’ falls as a priority
• Begin implementation with stakeholders and
partners.
• Advocate for required resources.
• Link with our provincial and federal counterparts to
collaborate regionally and nationally.
• Rally partners and continue to build capacity.
• Nova Scotia Health Promotion and Protection will
continue to lead coordination of strategy
Our Success Depends On…
• Leadership and collaboration across sectors.
• Partners doing their part to support the strategic
goals.
• Adjusting processes and policies – do things
differently and more effectively – not just a matter
of more money.
• Recognizing that we can impact this issue and
support sustainability of the health system.
Challenges
• Changing Behaviours
– Educate
– Change practice
• Create an environment that balances risk
and best practice for the high risk patient
• Creating an Age Friendly Environment
Falls Prevention Coordinator
Suzanne Baker
South Shore Health
Phone: (902) 634-8807 x3193
Email: sbaker@ssdha.nshealth.ca