Reducing the risk of patient falls in a hospital is important to the field, and now a handful of providers are taking a dedicated approach to preventing falls outside the hospital.
One of the latest to focus on fall prevention is a bi-weekly half-day clinic run by physical medicine and rehabilitation specialist Joseph Rosenthal, M.D. The clinic, held at Wexner Medical Center at the Ohio State University where Rosenthal is an assistant professor, is close to finishing its first year of trying to tackle the risk of a fall from a broader perspective.
"A lot of patients have multiple risk factors for falling — it might be cardiac, it might be medication, it might be balance, it might be their vision," Rosenthal says. "And a lot of times maybe none [of the risk factors] was being recognized, maybe just one was being recognized and addressed, but nobody was assessing them from head to toe," he says. "That was the idea behind the clinic," he says.
Working with a physical therapist, the team tries to determine what a patient's fall risks are. Patients who've had a fall or are afraid they may can visit the Columbus clinic, and often do so on the referral to a primary care doctor. After doing its work, the fall clinic refers patients back to the primary care doctor to implement its recommendations.
Rosenthal says his initial interest in starting the clinic was driven by a sharp increase in brain injury for older adults. "It's essentially becoming an epidemic," he says. Centers for Disease Control and Prevention data show the rates of traumatic brain injury-related death among those 65 and older climbing to 45.2 deaths per 100,000 in 2009–10 from 41.2 in 2001-02. Other age groups were basically flat or fell.
Rosenthal says his theory is that older adults more often want to remain independent longer than their parents' generation, which is leading to more falls that cause injury and death. That theory fits in well with what experts told me for a series H&HN ran on the aging of baby boomers.
The Wexner clinic is not the first of its kind. Rosenthal modeled it on a fall prevention clinic run by Harborview Medical Center, part of the University of Washington in Seattle, which was founded by geriatrician Elizabeth Phelan, M.D.
Rosenthal says the clinic's efforts "by coincidence" fit in well with the movement toward managing a patient's total health.
With so many independent-minded boomers aging, I'd guess others might start similar operations. If you know of any in the works or in operation, feel free to point them out below or via email, Twitter, and Google+.