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October 28, 2003


Emory Centers Awarded Funds To Study Management Of Falls In Long-Term Care Facilities

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 of Medicine.

"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 Quality.

"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.

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