TEAM STEADI—Less Senior Falls at Portland OHSU

Falls are the leading cause of fatal and nonfatal injuries among older adults aged 65 years and older. But falls aren’t an inevitable part of aging — and that’s the premise behind the STEADI (Stopping Elderly Accidents, Deaths, and Injuries) Initiative from the Centers for Disease Control and Prevention (CDC).

A key component of STEADI is the 3 evidence-based steps that providers can use during a single office visit to help lower the risk of falls in older patients:

  • Screen patients for fall risk (ask if they: have fallen in the past year, feel unsteady standing or walking, or worry about falling)
  • Review and manage medicines that increase fall risk
  • Recommend vitamin D supplements for improved bone, muscle, and nerve health

Meet Dr. Eckstrom
Dr. Elizabeth Eckstrom, Associate Professor and Director of Geriatrics at Oregon Health & Science University (OHSU), sees patients in the Internal Medicine & Geriatrics Clinic at OHSU, where they’ve been implementing STEADI since 2013.

“Our goal was to make sure everyone over 65 gets screened for falls,” says Eckstrom. “We wanted to integrate the screening into primary care — to really weave it into the fabric of what happens in the clinic.”

STEADI Implementation at OHSU by the Numbers

  • In the first 3 months after implementing STEADI, Eckstrom and her team completed 360 falls screenings.
  • Within 18 months, the clinic had screened over 870 patients — 45% of the patients aged 65 years and older who were seen during that time interval.
  • All of the clinic’s 45 internal medicine residents and 30 faculty providers have been trained as STEADI providers.

  • Lessons in Teamwork
    Eckstrom cites teamwork within her clinic as an important piece of the puzzle, too. “You need a team that works well together,” she says. “And in some ways STEADI really taught us how to do that. We got STEADI, we defined our roles — and it served as a catalyst for establishing good teamwork.”
  • She also mentions a valuable partnership between her clinic and the Oregon Health Authority (OHA), which had a CDC grant to support STEADI and community fall prevention programs in communities across the state. “That public health partnership gave us community resources that we needed to help our patients.”

Dr. Eckstrom speaks warmly of a woman who started experiencing falls around age 92. “When I discussed Tai Chi with her, she thought she was too old for it. But we found her a convenient class, and she tried it. Now she has totally stopped falling, and she even recruits her friends to do Tai Chi with her — at age 96!”

To see the full article:

See the STEADI Algorithm for the comprehensive assessment:

The STEADI Protocol 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 in ALL medical or senior living settings and can be integrated into Telehealth for follow-up!

EXCITING TIMES!  October 2019 U.S. Senate Committee on Aging report:

  • 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!

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