Ortho MD & PCPs Role for Senior Fall Prevention

Each year, approximately 30% to 40% of people aged 65 years and older who live in the community fall.

Primary care providers (PCPs) have a crucial role in helping patients understand the important factors causing falls. This also pertains to Orthopedic Doctors that did surgery repair because of a fall.

A 2012 Cochrane Systematic Review reported that clinical assessment by a health care provider combined with individualized treatment of identified risk factors, referral if needed, and follow-up reduced the rate of falls by 24%!

Below are the key findings and recommendations in this research article. At the bottom, you can see a link for the full article.

  • PCPs can receive reimbursement for fall risk assessment through the Medicare Annual Wellness visit and incentive payments for assessing and managing fall risk through voluntary participation in the Physician Quality Reporting System.
  • Providers can receive reimbursement for providing medically necessary fall-related services by using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code R29.6 for repeated falls.

The US Centers for Disease Control and Prevention (CDC) has developed the STEADI Algorithm that details each step of screening and assessment and guides interventions based on each individual’s level of risk.

  • Fall History
    • A fall history should include determining the number of falls in the past year as well as their circumstances, including any premonitory symptoms, location, activity, footwear, use of assistive device (if prescribed), use of glasses (if typically used), ability to get up after the fall, time of day, any injuries sustained, and any medical treatment received.
  • Medications and falls
    • A critical part of the risk assessment is a medication review.
  • Postural hypotension
    • Postural hypotension is defined as a reduction in systolic blood pressure of at least 20 mm Hg or in diastolic blood pressure of at least 10 mm Hg within 3 minutes of standing.

Involve relevant professional disciplines:

Physical therapist

PTs assess and treat balance, strength, and gait deficits. Timed Up-and-Go, 30-Second Chair Stand, and 4-Stage Balance tests PTs do as part of a comprehensive gait and balance, assessment. Then a treatment plan to address those deficits, including adaptive devices.

 Occupational therapist

OTs assess the home environment and evaluate older adults’ capacities (e.g., vision, cognition) and deficits about functioning safely within their homes and outside. Poor-fitting footwear and fall risk behavior is also assessed. Then a treatment plan is made for those deficits.

Connect patients to evidence-based fall prevention programs

Several effective fall prevention programs are becoming available in the community. For example, Tai Chi has been shown to reduce fall risk by 29%. In the home, the OTAGO exercise program has shown to be effective.

Ortho MDs, PCPs, etc. – please consider writing prescriptions for the STEADI Protocol.

  • We all want less hospital re-admissions and seniors living their sunset years, pain free as possible and thriving! 

For the full article: http://bit.ly/33kAbRd

STEADI coordinates well with the goals of value-based health care, better rehab outcomes, and decrease medical costs. Therefore, the quadruple aim is achieved. It has a multitude of evidenced based research. I’ve used STEADI successfully for 15 years. It is fun and easy to use!

EXCITING TIMES!  October 2019 U.S. Senate Committee on Aging report:  https://www.aging.senate.gov/imo/media/doc/SCA_Falls_Report_2019.pdf

  • How is your state doing, see page 10?
  • Upper State New York did a STEADI- based program and reduced hospitalizations due to falls by 40%! See pages 20-21
  • Examine how Epic EHR integrated STEADI. See how innovative programs in different states decreased senior falls with home environment safety changes, effective community balance programs, and medication recommendations

I provide Fall Prevention Classes to MDs, Medical Professionals, Insurance Companies and Senior Communities. Let’s decrease re‑hospitalizations! www.geriatricrehab.biz

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