CAHF 2014 Quality Symposium Falls Presentation

by Tim Gieseke MD, CMD

My decision to attend this past September’s CA Health Facility Foundation CME program was largely driven by my awareness that Sue Ann Guildermann would be presenting again on the Empira Fall Prevention Program. She is part of Empira, a Minneapolis company that does focused QAPI projects for a consortium of SNF companies using outcomes data submitted by these companies.  Her presentation on Falls Management was comprehensive, evidence-based, and challenged some strategies that I and my facilities have adopted as reasonable interventions to reduce Fall risk as well as the risk of injury should a fall occur.

Many of those strategies focus on limiting a patient’s mobility (Position Alarms, Low Beds, Defined perimeter mattresses, bedside landing mats, reclining wheelchairs, etc.), but lack evidence for reducing falls or fall injuries.  In addition, they may interfere with sleep, promote deconditioning with increased fall risk, and may increase the risk of skin breakdown and contractures.  I’ve attached a great summary article she provided on the value of an alarm reduction program as well as a consumer education piece for patients and families on the same subject.  In addition, she provided wonderful handouts on a facility process for initial falls investigation (10 questions) and falls scene investigation (FSI) tool, which I have attached.  I’ve now studied her presentation again and plan on using it as a foundation for discussing falls management in my facilities.   

As an attending physician and multi-facility Medical Director, I was disappointed by how few LTC physicians were at the meeting in Berkeley.  This was a quality meeting with an effective interdisciplinary content and opportunities for interactive learning.  As LTC medicine moves to a collaborative model, I challenge our physician and NP / PA readers to show up at future meetings that target facility IDT quality improvement.  I think you will be pleasantly surprised.

Attachments:

Resident Falls-10 Questions Guildermann.pdf

Rethinking Position Alarms Rader_072208_final.pdf  

Falls Scene Investigation Report.pdf

Falls Alarms Resident Brochure falsereassurance.pdf

Falls Brochure for Family and Friends.pdf