South King Fire & Rescue Fall Prevention Program: Training Intervention 1

Helping People Overview Faller Impact on SKFR Operations Fall Prevention Program Introduction Intervention – Methods – Goals – Predicted Outcomes KC EMS One-Step-Ahead Program 2

Helping People Training Objectives Examine faller impacts on current operations at SKFR Introduce the SKFR Fall Prevention Program Prescribe a new intervention for use with fall patients Familiarize you with the One-Step-Ahead program 3

Helping People Fall Patient Frequency 35-50% of adults 65+ fall annually nationwide 17% of EMS calls for fallers ages 65+ in King County 13,000 older adults served by SKFR (2010) – 86% in private homes 4

Helping People Lift Assist Frequency 5

Helping People Lift Assist Frequency 6

Helping People Impact on Operations ( ) 86 to 250 out-of-service hours – Cuts down time available for other non-acute calls – Trend expected to increase SKFR FF time loss injuries – 149 injury claims – 29 from lifting patients – 11 out of 29 from lift assist calls 7

Helping People Program Mission Statement To improve faller health outcomes by identifying repeat fallers early and increasing patient referrals to the One-Step-Ahead program. 8

Helping People Fall Prevention Program Objectives Objective #1: Improve timely identification of individuals who have called 911 for a fall (or more than one call for a fall) within the boundaries of SKFR. 9

Helping People Fall Prevention Program Objectives (continued) Objective #2: Implement department-wide intervention to increase EMTs referrals of fallers to the One-Step-Ahead program 10

Helping People Survey Results 41.86% Survey responders: – Were not aware of resources to give fall patients (60%) or referral programs (56%) – Had not referred previous fall patients (58%) and had not received follow-up information (38%) 86% of responders want to provide resources to fall-patients – 66% want follow-up via 11

Helping People Incident Type Codes Currently Used 90.7% 41.86% 4.65% 32.56% 9.3% 12

Helping People Intervention – Methods: how will you intervene? – Goals Referrals FireRMS – Predicted Outcomes 13

Helping People Methods 1.Respond & Treat 2.Counsel – Pamphlet resources 3.Fill out tear-away 4.FireRMS Incident Type code: 3111 (Patient Assist) 14

Helping People 1. Respond and Treat No deviation from current fall patient response – Elk and Camel – Scooching 15

Helping People 2. Counsel Tear-Away 16

Helping People 2. Counsel Tear-Away 17

Helping People 2. Counsel Additional Resources 18

Helping People 2. Counsel 19

Helping People 3. Fill out tear-away 20 Refer all fall patients, regardless of injury

Helping People Checklist 21

Helping People 4. FireRMS Code: 3111 FireRMS: – All non-injury fall patients to be coded under Incident Type as 3111 (Patient Assist) – Fall patients: anyone requiring lift assistance Include pre-existing conditions (diabetic neuropathy, obesity, Parkinson’s Disease, multiple sclerosis) Do NOT include falls resulting from seizures – Fall patients resulting in injury to be coded as usual 22

Helping People Additional Notes Refer ALL fall patients Please complete forms accurately and completely Emphasize safety and independence Route referral forms and any requests for additional resources to Community Affairs Office 23

Helping People What’s in it for me? Referrals to One-Step-Ahead will increase – Intervention should decrease number of repeat falls, but… Repeat fallers will continue to persist We can’t help everyone, but we can make a difference 24

One Step Ahead Fall Prevention Program 25

Program Goal:  Reduce re-occurring falls  Keep seniors in their home– safe and independent Program Outcome:  2003 Bellevue FD project study showed that 58% of participants did not have a fall after the intervention  Current program has 1,472 patients were enrolled into the program (as of December 2014) 922 female (62.6%) 550 male (37.4%) 82.6% of the fallers who completed the evaluation did not have a fall after the intervention One Step Ahead Fall Prevention Program 26

Called for a fall or at high risk of a fall as assessed by a healthcare professional 50 years or older living in King County. Living independently – not residing in assisted living facilities, nursing home, SHAG or KC Public Housing Participant Criteria 27

Education about fall prevention and home safety A home safety-walk through Free in-home safety devices Referral to other community resources Program Provides 28

 Patient denies falling or won’t tell anyone they fell due to being: Embarrassed Ashamed Afraid of losing their independence  Patients will blame a behavior - I wasn’t watching where I was stepping or an environmental situation – I tripped over the phone cord, instead of realizing it’s a health risk factor that may have caused the fall (medication, vision, or lack of mobility/strength) Possible Patient Issues 29

Questions? 30