Every second, an elderly person in the United States falls and injures, and every 20 minutes, one dies of that fall. More than 30 percent of adults aged 65 and over fall each year, and 25 percent have moderate to severe injuries. These falls result in 3 million emergency department visits, 800,000 hospitalizations and 30,000 deaths each year. This problem is particularly acute in Florida, where more than 3.3 million people are over the age of 65.
Although there are comprehensive guidelines for fall prevention, most efforts at the primary care and emergency department levels have not shown very promising injury prevention. In addition, primary care physicians rarely perform recommended routine fall risk assessments and fall prevention strategies.
Researchers at Florida Atlantic University Schmidt College of Medicine received a $ 1 million grant from the Florida Medical Malpractice Joint Underwriting Association for a two-year project called the Geriatric Emergency Department Project Prevention Injury Prevention Project (The GREAT FALL).
A randomized controlled trial will examine several emergency prevention strategies in elderly patients at high risk of recurrent falls and injuries. Tailored multi-component intervention identifies effective fall prevention strategies that target limited resources to high-risk individuals who come to the emergency room to improve patient outcomes, improve safety, and reduce overall healthcare costs.
“The Emergency Department provides an opportunity to focus efforts and maximize resources to reduce the risk of falls-related injuries,” said Richard Shih, MD, principal investigator, professor of emergency medicine and director of the Emergency Medicine Residential Program Division, FAU. Schmidt College of Medicine. “Importantly, elderly patients who get injured and come to the emergency room after a fall have an even higher risk of repeated falls and subsequent injuries. Targeting older individuals and their caregivers in the emergency department could therefore provide the most beneficial return if limited resources are available to increase the safety of these individuals. “
The “BIG FALL” builds on two previous FAU prevention projects: the “BIG STOP” to prevent head injuries in older adults taking blood thinners; and the “STAR” program, which included many different types of high-risk elderly patients. The “BIG STOPS” project involved about 6,000 patients with head injuries, the vast majority of whom suffered injuries as they fell from the ground. The work has led to a number of important findings regarding fall-related head injuries in the elderly population.
Shih leads a collaborative group of researchers in emergency medicine and geriatric medicine with extensive experience in this field. The team works with Delray Medical Center Palm Beach Health Network, which treats more than 50,000 adult patients in its emergency room and includes a busy Level 1 trauma center, the highest traumatic care available.
The main outcome measure of the study will determine the rate of recurrent falls requiring an emergency department visit and fall-related injuries during the six-month follow-up. Other secondary outcomes will include types of falls-related injuries, fall-related deaths and all-cause deaths.
Study participants will be randomized into three strategies: current care; telephone-based fall prevention strategies; and home prevention strategies. The telephone-based strategy will include providing easy-to-read materials to the patient and caregiver before discharge from the emergency department and a structured telephone call approximately 14 days after discharge. Home visit crash prevention strategies and telephone strategies are based on the US Centers for Disease Control and Prevention “Stoping Elderly Accidents, Deaths & Injuries”.
Florida is an ideal place to conduct this important study because it has the highest percentage of geriatric patients in the United States, and Palm Beach County in particular has more than 365,000 people aged 65 and over, making up 24.4 percent of the county’s population. Said Julie G. Pilitsis, MD, Ph.D., Dean and Vice President of Medical Affairs, FAU Schmidt College of Medicine. “This project will provide vital data on the best fall prevention strategies for high-risk individuals and improve their safety and patient outcomes.”
The study is co-investigated by Lisa Clayton, DO, Associate Professor of Emergency Medicine and Chair of the FAU Institute of Emergency Medicine; Joseph G. Ouslander, MD, Professor of Geriatric Medicine, Chief Adviser to the Dean and Editor-in-Chief Journal of the American Geriatrics Society; Scott Alter, MD, Assistant Professor of Emergency Medicine and Associate Research Director of the FAU Emergency Medicine Residency Program; Joshua Solano, MD, Associate Professor of Emergency Medicine and Director of Quality Improvement and Patient Safety, FAU Emergency Medicine Residency Program; and Patrick Hughes, DO, Associate Professor of Emergency Medicine and Assistant Program Director of the FAU Emergency Medicine Residency Program.
– FAU –
About Charles E. Schmidt College School of Medicine:
FAU’s Charles E. Schmidt College of Medicine is one of approximately 155 accredited medical schools in the United States. The college was launched in 2010. when the Florida Board of Governors made a landmark decision authorizing the FAU to award an MD. After approval by the Florida Legislature and Governor, it became the 134th Allopathic Medical School in North America. WITH more than 70 full-time and part-time faculties and more than 1,300 affiliated faculties, the college It matriculates 64 medical students each year and has been recognized nationally for its innovative curriculum. The FAU Charles E. Schmidt College of Medicine’s Postgraduate Medical Education (GME) consortium has supported the FAU’s commitment to increase much-needed medical residencies in Palm Beach County and ensure that the region continues to have an adequate and well-trained medical workforce. ) was established in the fall of 2011 with five leading hospitals in Palm Beach County. The consortium currently has five accredited residencies by the Accreditation Council for Postgraduate Medical Education (ACGME), including internal medicine, surgery, emergency medicine, psychiatry and neurology. Live research areas include healthy aging, neuroscience, chronic pain treatment, precision medicine and machine learning. With the community at the forefront, the college offers the local population a range of evidence-based clinical services that heal the whole person. The collaboration between FAU Medicine’s Primary Care and the Marcus Institute of Integrative Health has been designed to provide complete health and wellness under one roof.
About Florida Atlantic University:
Florida Atlantic University, founded in 1961, officially opened its doors in 1964 as the fifth public university in Florida. Today, the university serves more than 30,000 undergraduate and graduate students on six campuses along the southeast coast of Florida. In recent years, the university has doubled its research spending and outperformed its colleagues in terms of student success. Through the coexistence of approach and excellence, the FAU embodies an innovative model in which traditional gaps in success disappear. The FAU is described as an institution serving Hispanics, ranked as a top public university by the US News & World Report, and a high research institution by the Carnegie Foundation for the Advancement of Teaching. For more information, visit www.fau.edu.
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