February 2018

Strengthening the Interprofessional Approach to Fall Prevention

Elizabeth W. Peterson, PhD, OTR/L, FAOTA

Health care professionals who work with older adults are all too familiar with the devastating sequelae of falls, including injury and fear of falling that can lead to activity restriction and further risk of falls. Most worrisome is that death rates from falls have doubled between 2000 and 2014,1 which highlights the importance of sustaining existing fall prevention efforts, and of building new ones. The statistics and complexity of fall prevention demonstrate a clear need for interprofessional approaches to reduce fall risk among older adults.

Key resources for clinically-based, interprofessional fall prevention efforts in the United States are the American and British Geriatric Societies (AGS/BGS) fall prevention guideline2 and the Centers for Disease Control and Prevention’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative.3 Further imperatives for interprofessional approaches are the US patient safety movement and the Patient Protection and Affordable Care Act, which focus on the value and quality of medical services.4,5

The newly established National Council on Fall Risk Awareness and Prevention (NCFRAP) represents an effort to build on these initiatives. This interprofessional group includes10 volunteering health care clinicians and researchers who collectively have expertise in balance assessment and intervention, and fall prevention. Members include an MD and assistant professor at Johns Hopkins University School of Medicine; a PhD, director of surgery and director of clinical research at Baylor College of Medicine; a PhD and physical therapist who is an associate professor at Upstate Medical University; a PhD in biomechanics; as well as the two writers of this editorial.

Mariana Wingood, DPT, PT, GCS, CEEAA

Initial Council meetings have yielded clear goals, including the creation of compendia to STEADI that support diverse health care providers in their efforts to screen for modifiable, lower extremity fall risk factors and make appropriate referrals to address identified risk factors. A review of the literature to inform the development of these resources is underway, and results from the Council’s efforts will be disseminated through a variety of channels ranging from conference presentations and publications, to consumer publications and social media outreach.

The result of the Council’s near and long-term work will help secure the standing of a strong segment of LER’s readership — podiatrists, physical and occupational therapists, pedorthists, and orthotists – as central in the identification and treatment of fall risk in our senior population. The Council’s work highlights the benefit of drawing from evidence-based fall prevention resources and working within one’s sphere of influence to address the formidable problem of falls.

Each member of the health care community serving older adults has a unique opportunity to build upon the attention to both fall prevention and interprofessional collaborative practice that is occurring nationally. Each healthcare professional brings value to fall prevention, and, through interprofessional efforts, we can amplify that value.

Elizabeth W. Peterson is clinical professor and director of professional education in the department of occupational therapy at the University of Illinois at Chicago.

Mariana Wingood is a physical therapist at the University of Vermont Medical Center in Burlington, VT.

REFERENCES
  1. Web-based Injury Statistics Query and Reporting System (WISQARS) Centers for Disease Control and Prevention website http://www.cdc.gov/injury/wisqars. Accessed February 9, 2018.
  2. Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society. Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011;59(1):148-57
  3. Stevens JA, Phelan EA. Development of STEADI: a fall prevention resource for health care providers. Health Promot Pract. 2013;1 4(5):706-714.
  4. Dow A, Thibault G. Interprofessional education — a foundation for a new approach to health care. N Engl J Med. 2017;377(9):803-805.
  5. Case-Smith J, Page SJ, Darragh A, et al. The professional occupational therapy doctoral degree: why do it? Am J Occup Ther. 2014;68(2): e55–e60.
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