Emory Centers Awarded Funds To Study Management Of Falls In Long-Term
ATLANTA – As many as 75% of nursing home residents fall annually,
twice the rate of seniors living in the community. And now, a federal
agency is supporting a study by Emory University on how best to manage
and minimize the problem.
The collaborative effort of the Emory Center on Health Outcomes and
Quality and the Emory Center for Health in Aging have been jointly funded
by the Agency for Healthcare Research and Quality (AHRQ) for $375,775
to study the management of falls in long-term care facilities. The two-year
project that begins in January 2004, will build on the Falls Management
Program (FMP), a previous AHRQ-funded program that developed fall-related
education strategies and standardized and computerized reporting forms.
The goal of the newly-funded project is to rapidly disseminate the tools
and products of the Falls Management Program into a real-world setting.
Emory co-investigators for the project are Kimberly Rask, MD, PhD, director
of the Emory Center on Health Outcomes and Quality and associate professor
of health policy and management, Rollins School of Public Health and
Joseph Ouslander, MD, director of the Center for Health in Aging and
head of the Division of Geriatric Medicine and Gerontology in the School
"The existing data collection tools for nursing homes donít accurately
capture fall risk factors for the residents," says Dr. Rask. "Even when
a resident assessment plan is developed, the existing tools donít provide
specific enough guidance to help staff develop individualized care plans
that can reduce fall risks and thus prevent them. Many falls can be
prevented if appropriate protocols are followed."
The Emory team will build on the work developed by the Falls Management
Program by initially utilizing its quality improvement tools in 26 nursing
homes in Georgia. The selected community-based nursing homes are owned
and operated by Ethica Health & Retirement Communities, a Georgia non-profit
company and member of the Southeastern Consortium for Long Term Care
"We will be streamlining the previously developed educational materials
and quality improvement tools in such a way that they can be incorporated
into standard practices at the participating nursing homes," Dr. Rask
says. "If successful, the project could result in widespread dissemination
of these tools to improve the management of falls in nursing homes."
According to the National Center for Injury Prevention and Control of
the Centers for Disease Control and Prevention, a typical 100-bed nursing
home reports 100 to 200 falls each year, yet many others go unreported.
"Risk factors for falls are well known, and can be attributed to mobility
disorders, incontinence, co-existing medical diseases or medication
side effects," Dr. Ouslander says. "Falls among residents are also a
major cause of morbidity, health care expenditure, and legal liability
in nursing home facilities. Reducing falls will have a significant impact
on quality of life as well as health care costs."
Dr. Rask concludes that many promising research findings are never translated
into actual improvements in clinical care because the research model
is too labor or expertise intensive to be adopted widely. With the new
project, she says, fall and injury rates will decline over the course
of the project, although there may be an initial increase in rates because
of the improved reporting of falls.
"If we are successful, we will have created a model program that can
be rapidly and easily implemented in community nursing homes across
the country, making a real impact on reducing the rates of preventable
falls," she says.