CME for Physicians

Falls Algorithm and Tools

Champlain Falls Prevention Strategy – Algorithm and Staying Independent Checklist

In 2012, the Champlain Local Health Integration Network funded project management in order to support the mandate of the Ontario Ministry of Health and Long Term Care's Integrated Provincial Falls Prevention Framework and Toolkit which was initiated in July 2011. A number of working groups were struck, one specifically to develop an algorithm for community and primary care practitioners that would help to A) promote system-wide health promotion and intervention, and B) to determine the root causes of falls and to facilitate appropriate referral and intervention. The working group determined that an abridged version of the American Geriatric Society (AGS) and British Geriatric Society (BGS) algorithm[1] with some expansion around prioritization and the nature and type of assessment, would best meet the needs of Champlain practitioners. In addition, the step-wise process developed by the RGP's Geriatric Assessment Outreach Team (GAOT)[1] provided greater guidance in evaluating and treating fall risk. Concurrently, a number of assessment and screening mechanisms were reviewed and the decision taken that the checklist originally developed by Rubenstein et al 2011[2] in Los Angeles and adapted by the British Columbia Ministry of Health, Senior's Fall Prevention division[3] provided a comprehensive self screening mechanism which concurrently encouraged seniors to participate in their own health evaluation but also assisted clinicians in measuring a level of vulnerability. The checklist was viewed as a tool that could be used independently in community settings such as pharmacies, public health clinics, and community support agencies and would be included in the algorithm as one component in the first level screening in the decision making process.

These tools were tested in a pilot study between November 2013 - February 2014, and revisions were made based on the recommendations of the participants. The revised algorithm is included here and is recommended for use in primary care practices. It is recommended that, where possible, the algorithm should be included as part of a practitioner's electronic record - some examples of integrated templates will be available by March 2015.

Falls Algorithm

Staying Independent Checklist

Timed Up and Go Fact Sheet

What To Do If You Fall

GiiC Pamphlet, Seniors Falls Can Be Prevented

You CAN Prevent Falls

[1] Based on American Geriatric Society and British Geriatric Society Algorithm May 2010

[2] This checklist was developed by the Greater Los Angeles VA Geriatric Research Education Clinical Centre and affiliates and is validated fall risk self-assessment tool (Rubenstein et al. J Safety Res; 2011:42(6)493-499).

[3] British Columbia Ministry of Health, Senior's Fall Prevention division