Fall prevention: Identifying the knowledge gap among residents
This study explores gaps in fall prevention practices and community resource awareness among medical trainees treating older adults in London, Ontario.
Background
Falls are a significant cause of morbidity and mortality in older adults. As a majority of baby boomers reach the age of 65 and older, the number of incidents related to falls is expected to increase (Salkeld et al., 2000). In addition to the high number of incidents, susceptibility to high severity injury and loss of independence in this population group due to falls are major factors that require consideration. In a 2018 report by Canadian Institute for Health Information, falls among older adults were the most common cause of injuries and the primary reason for hospital visits among this age group. To put it in numerical terms, there are roughly 653,808 Emergency Department visits due to unintentional falls in Canada per year, making this 32% of all reported visits secondary to fall injury (Health Canada, 2020). Health Canada has also reported that falls cause 95% of all hip fractures, with a mortality rate of 20% within the same year. Healthcare costs associated with falls are estimated to be roughly $2 billion a year and account for 85% of all injury-related hospitalizations in older adults (Health Canada, 2020). Informal interviews with several medical residents at the University of Western Ontario revealed that patients presenting with falls are screened for risk factors upon admission. However, once the primary concern has been resolved, they are discharged from the hospital and sent home without a specified plan to avoid future falls. This is concerning as literature suggests a history of previous falls increases the risk of subsequent falls threefold (Rubenstein et al., 2002). These same informal interviews also revealed resident physicians believe they lack awareness of programs offered in their communities for fall prevention, and therefore do not refer patients to these programs. Furthermore, with no structured system in place, they also do not provide any fall-preventative education to these patients. Methods for fall prevention in the elderly population have been studied, and several interventional techniques and programs have been implemented as part of community programs. In Ontario, the primary resource center for its provincial regions is through LHINs (Local Health Integration Networks). In these government-funded organizations, resources such as access to fall preventative methods, including exercise classes, home assessment by occupational therapists, and access to other allied health groups are available. These resources aiming to prevent falls in the elderly can be accessed by self-referral as well as a referral by the patient’s family member, hospital physician, or primary care providers. The need: to gain perspective and identify whether there is a knowledge gap among healthcare providers-in-training in London, Ontario at the University of Western Ontario.
Project team
- Leeda Bashardost
TRP supervisors
Project advisory committee
- Christopher Watling
- Jaspreet Bhangu
See our community directory for more on committee members.