Are patients falling through the cracks of fall prevention?

Background: The San Diego Fall Prevention Task Force conducted an in-depth assessment to identify needs and assets related to falls in the East Region of our County. In follow-up, we created a Toolkit and on-line resource guide with the goal of increasing primary prevention and referrals to community resources.

Purpose: To understand the extent of falls, and to ascertain seniors' perceptions and experiences with falls in the healthcare system, as well as providers' perceptions of barriers to providing more comprehensive primary fall prevention.

Methods: A quantitative analysis was conducted to establish fall rates. Assets were mapped to produce a database of current fall prevention resources. We conducted a qualitative study consisting of focus groups with seniors and key informant interviews with clinicians.

Results: The East Region had higher rates of falls than any other Region in the County. Our qualitative study found that patients and doctors do not discuss fall risk before falls occur. Very few seniors received referrals to or were aware of proactive programs. Key informant interviews with providers indicated barriers to primary prevention, including lack of time and reimbursement, and lack of knowledge of community resources.

Conclusions: A Fall Prevention Toolkit was designed and distributed to providers. Evaluation with users of the Toolkit showed that it was indeed useful in facilitating prevention. However, they still did not use the new on-line resource guide to make referrals to services such as exercise programs and home modification. Future work will focus on increasing the use of this referral guide.