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INTRODUCTION OF A HOME BASED FALLS MEDICAL ASSESSMENT

INTRODUCTION OF A HOME BASED FALLS MEDICAL ASSESSMENT. FALLS SPECIALIST SERVICE PENINSULA HEALTH Vicki Davies Manager Falls Prevention Service. Peninsula Health Falls Clinic Background. Multi disciplinary Falls Clinic held twice monthly with a capacity of 3 clients per Clinic

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INTRODUCTION OF A HOME BASED FALLS MEDICAL ASSESSMENT

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  1. INTRODUCTION OF A HOME BASED FALLS MEDICAL ASSESSMENT FALLS SPECIALIST SERVICE PENINSULA HEALTH Vicki Davies Manager Falls Prevention Service

  2. Peninsula Health Falls Clinic Background • Multi disciplinary Falls Clinic held twice monthly with a capacity of 3 clients per Clinic • Clients may require initial assessment or 3 month medical review • Consists of Geriatrician, Physiotherapist and Dietician with pre-Clinic Occupational Therapy home assessment

  3. Falls Clinic Referrals • In the 6 month period from September 2004 to March 2005, 139 clients were referred to the Falls Specialist Service for initial assessment (conducted at home) • Of those clients 43 required further assessment at the Falls Clinic (31%)

  4. Analysis of Falls Clinic Waiting List • In March 2005, 28 clients were on the Falls Clinic waiting list for initial assessment with an additional 4 requiring medical review • 6 had been waiting 3 months or less (21%) • 18 had been waiting between 3 and 6 months (64%) • 4 had been waiting greater then 6 months (14%)

  5. Proposed Strategies for Reducing Falls Clinic Waiting List • Introduce a second Falls Clinic – but need to consider availability of venue and availability and cost of Geriatrician and Allied Health staff • Conduct medical reviews separate to Falls Clinic – but only a small number of these • Introduce a home based medical assessment

  6. Implementation of Home Based Medical Assessments • Developed selection criteria – frail, no access to transport, no significant Physio needs • Collaborated with Dept Aged Care Medicine to release Doctor for one session per week • Falls Care Coordinator accompanied Doctor • Vehicle supplied via Hospital car pool • Admin support provided by Falls Service

  7. Review of Recommendations Made • In 12 week period following implementation 20 assessments were conducted • Major recommendations made were: • Further medical investigation by LMO (60%) • Community strengthening program (40%) • Centre based Physiotherapy (20%) • Increased/changed use of gait aid (15%) • Inpatient rehabilitation (15%)

  8. Feedback Sought From Clients • 45% response rate • 100% happy with the way assessment was conducted • 89% received adequate feedback on Doctor’s recommendations • 78% preferred home based assessment to clinic based

  9. Feedback Sought From LMO’s • 56% response rate • 89% aware assessment had been conducted • 67% received adequate feedback • 89% happy for Falls Care Coordinator to decide on location of medical assessment (home based versus Falls Clinic)

  10. Summary • Home based medical assessments provided a cost effective option to reduce Falls Clinic waiting list • Provided more accessible and equitable services for frail or housebound clients • Majority of clients and LMO’s were happy with the service • Could only be achieved through collaboration of Falls Prevention Service and Aged Care Medicine

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