Improving the Care of Fall Injured Elders in U.S. Emergency Departments
DOI:
https://doi.org/10.17140/EMOJ-3-135Keywords:
Elderly falling, Fall prevention, Geriatric, Emergency departmentAbstract
Objective: Geriatric fall-related injuries have become a fatal public health crisis in America which has affected the population at an ever growing rate. America’s Emergency Departments (EDs) are the heart of the problem and the solution towards preventing geriatric falls. The purpose of the study reported here is to address the concerns associated with the quality of care that American EDs provide to their fall-injured geriatric patients.
Methods: To address these concerns (see supplementary data) a survey was conducted in April/May of 2015 among 800 ED physicians of American College of Emergency Physicians (ACEP). Approximately, 83% of the physicians (N=660) responded to the survey which was designed and analyzed by the authors. Data was appropriately analyzed using the chi-square test of goodness of fit.
Result: Most of the physicians participating the survey perceived that none of these diagnostic observations like balance, gait, vision, hearing, physical therapy needs, clinical depression, fear of falling, etc., are routinely provided to fall-injured elders in their ED. Sixty-three percent of the physicians perceive that these fall injured patients routinely leave the ED without a documented appointment with a medical provider for follow-up diagnosis or evaluation. Sixty-two percent of the physicians associated with the survey believe that fall injured patients return to the same ED almost 26-59% of the time. Sixty-six percent of the respondents would recommend that they and their colleagues take an 8-hour online course in geriatric fall prevention. Fifty-seven percent of our respondents were likely to refer high fall risk ED geriatric patients to a nearby Center of Excellence in Geriatric Fall Prevention and Treatment (CGFPT).
Conclusion: American ED physicians agreed on two initiatives: Firstly, 66% of the surveyed physicians agreed that they and their colleagues need to be more informed about geriatric fall prevention (via an online course). Secondly, 57% would recommend the creation of nearby CGFPT to which they can refer high fall-risk patients. Adoption of these two strategies would possibly help improve the healthcare of full injured geriatric ED patients in future.
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