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South King Fire & RescueFall Prevention Program:

Training Intervention

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Helping PeopleOverview

• Faller Impact on SKFR Operations• Fall Prevention Program Introduction• Intervention– Methods– Goals– Predicted Outcomes

• KC EMS One-Step-Ahead Program

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Helping PeopleFall 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

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Helping People2006-2010 Lift Assist Frequency

Year 2006 2007 2008 2009 2010 TotalLift Assists 266 286 419 571 797 2339EMS calls 10485 10843 11634 10780 11102 54844Proportion 2.50% 2.60% 3.60% 5.30% 7.20% 4.30%

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Helping PeopleImpact on Operations (2006-2010)

• 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

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Helping PeopleProgram Mission Statement

To improve faller health outcomes by identifying repeat fallers early and increasing patient referrals to the One-Step-Ahead program.

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Helping PeopleSurvey 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 e-mail

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Helping PeopleIncident Type Codes Currently Used

90.7%

41.86%

4.65%

4.65%

32.56%

9.3%

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Helping PeopleMethods

1. Respond & Treat2. Counsel– Pamphlet resources

3. Fill out tear-away4. FireRMS Incident Type code: 3111 (Patient

Assist)

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Helping People1. Respond and Treat

• No deviation from current fall patient response– Elk and Camel – Scooching

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Helping People2. Counsel

Additional Resources

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Helping People2. Counsel

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Helping People3. Fill out tear-away

Refer all fall patients, regardless of injury

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Helping PeopleChecklist

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Helping People4. 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

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Helping PeopleAdditional 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

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Helping PeopleWhat’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

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One Step AheadFall Prevention Program

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 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

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• Called 9-1-1 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

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Education about fall prevention and home safety• A home safety-walk through• Free in-home safety devices• Referral to other community

resources

Program Provides

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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

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Questions?