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10-10 Draft of Falls Prevention Plan - Ohio Older Adult Falls

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10-10 Draft of Falls Prevention Plan - Ohio Older Adult Falls Powered By Docstoc
					4
                                                              2010 - 2014
             Ohio Injury Prevention Partnership
             Ohio Older Adult Falls Prevention Action
                                               Group




                                                              9/09/10




Older Adult Falls Prevention Coalition Goals and Objectives             Page 1
r
Ohio Injury Prevention Partnership (OIPP)
The OIPP is a group of professionals representing a broad range of agencies and organizations concerned with
building Ohio’s capacity to address the prevention of injury. A partnership of the Ohio Department of Health (ODH)
with funds from the CDC, the OIPP helps to improve statewide collaboration around injury and will assist ODH with
establishing priorities and future directions regarding injury and violence prevention in Ohio. Current priority areas
include child/youth injury, drug poisoning, and falls among older adults.

       Mission: To prevent injuries in Ohio using data and collaborative partnerships.

       Vision: Working together to create a safe and injury free Ohio.



Ohio Older Adult Falls Prevention Coalition
   As a result of an ODH grant and in close collaboration with ODH and the OIPP, the Ohio Older Adult Falls
   Prevention Coalition was formed. The Coalition is comprised of professionals from a range of agencies and
   organizations throughout Ohio. The function of the Coalition is to identify priorities statewide which can lead
   communities to address the particular areas that are of the greatest need for their populations; determine broad
   focus areas, goals, objectives and activities to guide communities and the state in addressing these issues; and
   to monitor progress in each of five priority areas. The priority areas are education/awareness, infrastructure,
   policy, interventions/risk assessment, and monitoring trends.

       Mission: The mission of the Ohio Older Adult Falls Prevention Coalition is to reduce the risk of falls
       through partnerships, education and policy.

       Vision: Older Ohioans will have fewer falls and fall-related injuries, maximizing their independence
       and quality of life.




Older Adult Falls Prevention Coalition Goals and Objectives                                                      Page 2
Older Adults
Falls Among Older Ohioans - Ages 65 and Older
Ta ken from ODH report: Burden of Injury From Uninte ntional Falls in Ohio, 2002-05

Falls are particularly harmful to older adults. Falls and fall-related injury seriously affect older adults’ quality of life
and present a substantial burden to the Ohio health-care system. They easily surpass all other mechanisms of
injury as a cause of ER visits, hospitalization and death. Important findings related to falls among older adults
include:

      Falls among older adults have reached epidemic proportions and rates continue to rise.
      Older adults account for a disproportionate share of fall-related injury.
      The likelihood of falling and the severity of fall-related injury increases with age, and therefore the risk for
       hospitalization and death also rise with age.
      Age and gender play a large role in determining risk for type of fall.
      Older adults with poor health status and those who are isolated are at greater risk of falling.
      Fatal and medically-treated falls represent only a proportion of all falls among older adults.
      Additional resources for prevention of falls among older adults are needed.



Falls Prevention in Older Adults Literature Review
Introduction

Falling is a serious public health problem among elderly people because of its frequency, the morbidity associated
with falls, and the cost of the resulting health care. i CDC reports that in the United States, 30% of older adults aged
65 or older living in the community and more than 50% of those living in residential care facilities or nursing
homes fall every year. This rate rises with age, with functional impairment and disability being highest in those
older than 90 years. Among older adults, falls are the leading cause of injury deaths and the most common cause of
nonfatal injuries and hospital admissions for trauma. In 2000, CDC found that traumatic brain injury accounted for
46% of fatal falls among older adults. Most fractures among older adults are caused by falls. The most common
fractures are of the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand. And astonishingly, in 2000, direct
medical costs totaled $179 million for fatal falls and $19 billion for nonfatal fall injuries.




Older Adult Falls Prevention Coalition Goals and Objectives                                                            Page 3
Older Adults
Falls Prevention in Older Adults Literature Review                            (continued)

The Ohio Department of Health (ODH) reports that falls among older adults in Ohio have reached epidemic
proportions, and account for a disproportionate share of fall-related injuries. ii In 2005, older adults accounted for
20% of all fall-related ER visits, and 71 % of fall-related inpatient discharges and 81% of deaths, while they only
represented 13% of the overall Ohio population. iii

During the time period 2002-2005, there were approximately 160,446 falls in Ohio. In 2006, the ODH performed a
Behavioral Risk Factor Surveillance Survey, and specifically asked respondents if they had experienced a fall in the
last 3 months and 14.3 % of Ohio respondents aged 65 or older indicated that they fell in the previous three
months. This percentage amounts to 215,000 persons who suffered at least one fall. And about 31.6% (69,217) of
those who fell reported that they had sustained an injury that resulted in a doctor visit or restricted activity during
the previous three months. For both male and female, the estimated prevalence of falling for ages 65-74 was lower
than ages 75 and older (11.4% versus 17.2% overall.)iv As for medical costs, according to The Burden of Injury
from Unintentional Falls, 2002-2005 Report, the total medical costs for nonfatal, hospital-admitted falls in Ohio for
older adults aged 65 or older was $327,366,900 in 2003.v

Many studies have agreed that the risk of falling and incurring an injury from a fall is greater in elders with poor
health status. And as the number of health issues increase so does the likelihood of falling. According to ODH’s The
Burden of Injury from Unintentional Falls, 2002-2005 Report, it states that older adults with chronic conditions that
lead to altered sensory or motor systems are particularly at risk for falls. vi Other fall risks listed were prescription
drug interactions, impaired cognitive function, use of alcohol, history of falls, and reduced vision cues, among
others.

Falls and fall-related injuries cause significant mortality, disability, medical costs, and loss of independence. vii Many
people, who fall, even those who are not injured, develop a fear of falling. This fear may cause them to limit their
activities, leading to reduced mobility and physical fitness, therefore increasing their actual risk of falling. viii These
injuries impose an enormous burden on individuals, society, and the nation’s health care system. The topic of fall
prevention is important because as the U.S. population ages, the impact of these injuries will increase. The
Administration on Aging reports in the Profile of Older Americans 2008 that the older population--persons 65 years
or older--numbered 37.9 million in 2007, and will increase to 40 million by the end of 2010 (a 15% increase) and
then to 55 million in 2020 (a 36% increase for that decade). By 2030, there will be about 72.1 million older
persons, almost twice their number in 2007.


Older Adult Falls Prevention Coalition Goals and Objectives                                                           Page 4
Older Adults
Ohio Older Adult Falls Prevention Action Group


Table of Contents

GOAL 1: EDUCATION/AWARENESS FOR OLDER ADULT FALLS PREVENTION .................................................................. 6

GOAL 2. INFRASTRUCTURE................................................................................................................................................. 9

GOAL 3: POLICY ................................................................................................................................................................ 13

GOAL 4: INTERVENTIONS/RISK ASSESSMENT................................................................................................................ 18

GOAL 5. MONITORING TRENDS FOR FALL-RELATED DATA ............................................................................................. 20

EVIDENCE-BASED INTERVENTIONS AND RESOURCES.................................................................................................... 25

CONTRIBUTORS................................................................................................................................................................. 26

REFERENCES ...................................................................................................................................................................... 27




Older Adult Falls Prevention Coalition Goals and Objectives                                                                                                                 Page 5
Older Adults
         Goal 1: Education/Awareness for Older Adult Falls Prevention

         1. To improve the fall prevention knowledge and behaviors among seniors and caregivers through
            community education and awareness efforts.

Objectives             Activities                               Implementation      Expected                Partners        Funding
                                                                Timeframe           Outcomes                                Implications

1.1 To increase the    1.1.1 Develop Web content for            From 2010-2011      Material w ill be       ODH, OPHA,      May need
know ledge of risk     ODH’s injury prevention Web site                             recommended for         Coalition       additional funding
factors, prevalence,   that provides tools for risk                                 ODH website and         member          to add a Fall
consequences, and      assessment and prevention tips.                              posted on OPHA          organizations   Prevention-
prevention                                                                          website                                 specific page to
strategies among                                                                                                            the OPHA website
community
members and
seniors.               1.1.2. Link with partnered               Ongoing 2010-2014   Organizational          All Coalition   Current funding or
                       organizations and agencies’ Web                              partner websites will   member          in-kind resources
                       sites.                                                       be listed on OPHA       organizations
                                                                                    and ODH websites



                       1.1.3. Offer 4-5 regional conferences    From 2011-2012      Conferences will be     All Coalition   Additional funding
                       on fall risk factors and prevention                          held and evaluations    members and     will be needed to
                       strategies.                                                  summarized              others as       support these
                                                                                                            identif ied     conferences



                       1.1.4 Identify and engage state and      From 2010-2014      Additional agencies/    All Coalition   Current funding
                       local health/aging organizations and                         organizations will      member
                       agencies to discuss and integrate fall                       participate in state    organizations
                       prevention awareness, risk                                   or local Fall
                       assessment and intervention                                  Prevention
                       strategies based on the venue where                          Coalitions
                       older Ohioans reside.

Older Adult Falls Prevention Coalition Goals and Objectives                                                                            Page 6
Older Adults
1.2 To increase the    1.2.1. Identify c ounty champions         From 2010-2014     List of champions       All Coalition    Current funding
know ledge of fall     representing each of Ohio’s counties.                        will be available and   member           and in-kind
risk factors and                                                                    posted to websites,     organizations    resources from
prevention                                                                          including counties      and local        existing network
strategies among                                                                    represented             partners
caregivers, and
health care
providers.             1.2.2 Provide awareness, risk             From 2010 - 2014   Information will be     United Way       Additional funding
                       assessment and intervention                                  disseminated;           agencies and     may be needed to
                       information to “2-1-1” information                           feedback data on        AIRS             collect and
                       centers” across the state through                            website “hits” or       information      summarize these
                       county champions.                                            places shared will be   systems; all     data
                                                                                    requested               Coalition
                                                                                                            member
                                                                                                            organizations



                       1.2.3 Develop a toolkit/press kit for     From 2010-2014     Toolkit will be         All Coalition    Current funding
                       use throughout Ohio and link to it                           developed and           member           and in-kind
                       online.                                                      posted online; can      organizations,   resources; some
                                                                                    be shared by            ODH, ODA         additional funding
                                                                                    electronic mail                          may be needed to
                                                                                                                             print some toolkit
                                                                                                                             items for those
                                                                                                                             without Internet
                                                                                                                             access, and to
                                                                                                                             address multiple
                                                                                                                             languages

1.3 To increase        1.3.1. Hold legislative fall prevention   From 2011-2014     Fall Prevention         All Coalition    Funding w ill be
know ledge of risk     educational event at the statehouse.                         Awareness Day           member           needed to support
factors and                                                                         event will take place   organizations    this activity
prevention                                                                          at the statehouse
strategies among                                                                    annually
policy makers


Older Adult Falls Prevention Coalition Goals and Objectives                                                                             Page 7
Older Adults
                       1.3.2 Obtain proclamation from         From 2010-2014   Proclamations/          ODH/ODA/         Current funding
                       Governor declaring Fall Prevention                      resolutions will be     OPHA
                       Awareness Week/Day.                                     obtained and shared
                                                                               on websites, via e-
                                                                               mail and through
                                                                               the media


1.4 Identify systems   1.4.1 Engage state associations to     From 2010-2014   Lists of potential      All Coalition    May require
that have              distribute fall prevention                              organizations/          member           additional funding
health/aging           information.                                            associations will be    organizations,   to coordinate this
association                                                                    developed; letters of   other            effort and produce
meetings                                                                       commit ment to be       associations     summary
                                                                               sent/returned           as identified




Older Adult Falls Prevention Coalition Goals and Objectives                                                                       Page 8
Older Adults
         Goal 2. Infrastructure

         1. To create a sustainable system which identifies needs, existing resources and gaps.

Objectives            Activities                              Implementation     Expected                Partners          Funding
                                                              Timeframe          Outcomes                                  Implications

1.1 To perform        1.1.1 Identify or develop valid,        From 2010 - 2011   A tool is identif ied   ODA/ODH/          Current funding
system-level needs    reliable needs assessment tool at                          and a process is        selected          and in-kind
assessment and        state and local levels.                                    developed to use it.    Coalition         efforts of
review available                                                                                         members           Coalition
data.                                                                                                                      members



                      1.1.2 Identify existing assessment      From 2010 - 2011   Data sets identified    ODA/ODH/          Current funding
                      data.                                                      and listed              selected          and in-kind
                                                                                                         Coalition         efforts of
                                                                                                         members           Coalition
                                                                                                                           members



                      1.1.3 Review resulting assessment of    From 2011 - 2012   Report on needs         ODA/ODH/          Current funding
                      the needs of professionals, older                          identif ied is          selected          and in-kind
                      adults, caregivers to gather their                         produced and            Coalition         efforts of
                      points of views.                                           shared                  members           Coalition
                                                                                                                           members



                      1.1.4 Identify both real and            From 2011 - 2012   Stakeholder input is    All Coalition     Additional
                      perceived, quantitative and                                obtained and            member            funding may
                      qualitative needs as determined by                         considered/ included    organizations     be needed
                      key stakeholders in the community.                         in report               and others to
                                                                                                         be identif ied.




Older Adult Falls Prevention Coalition Goals and Objectives                                                                         Page 9
Older Adults
1.2 To perform        1.2.1 Determine how the data are to     From 2010-2011   Assessment tool         Key               Current funding
resources             be gathered; who will gather the                         developed and           informants/
assessment by         data; and analyze the validity of the                    process identified to   Coalition
identifying risk      data.                                                    collec t/analyze data   member
factors and related                                                                                    organizations,
state resources.                                                                                       hospitals, etc.



                      1.2.2 Identify and list resources       From 2010-2011   Resource list           Pharmacy,         Current
                      focused on medication management ,                       compiled and shared     medical,          funding
                      fear of falling, sensory impairments,                                            vision, speech
                      etc.                                                                             and hearing
                                                                                                       and other
                                                                                                       health
                                                                                                       professionals
                                                                                                       and
                                                                                                       organizations

                      1.2.3. Identify and list resources      From 2010-2011   Resource list           State and local   Current
                      focused on physical activity/mobility                    compiled and shared     public health,    funding
                      and environment.                                                                 PT/OT orgs,
                                                                                                       universities,
                                                                                                       researchers,
                                                                                                       YM/WCAs, and
                                                                                                       other Coalition
                                                                                                       members,
                                                                                                       builders
                                                                                                       associations,
                                                                                                       city planners
                                                                                                       and county
                                                                                                       commissioners




Older Adult Falls Prevention Coalition Goals and Objectives                                                                        Page 10
Older Adults
         2. To develop strategies to fill the gaps in order to reduce the number of falls and fall-related
            injuries.

2.1 Identify gaps    2.1.1 Develop resource guides of who     From 2011-2013   Resource guides         Coalition           Additional
and connect them     is doing what and where (e.g. Central                     developed and           member              funding may
with resources.      Ohio - see website example).                              shared – online         organizations,      be needed to
                                                                               preferred               information         collect and
                                                                                                       and referral        update the
                                                                                                       organizations,      guide
                                                                                                       (ADRC’s and
                                                                                                       211 systems)



                     2.1.2 Share and update resource          From 2011-2014   Web-resource “go-       Coalition           Funding w ill be
                     information with colleagues in                            to” site developed,     member              needed to
                     education/awareness capacities (to                        updated and             organizations       monitor quality
                     meet Alliance of Information and                          promoted                and other           of resources
                     Referral Systems standards)                                                       identif ied         listed and to
                                                                                                       organizations       provide frequent
                                                                                                                           updates; can link
                                                                                                                           to Admin on
                                                                                                                           Aging Funding
                                                                                                                           already in place


2.2 Facilitate       2.2.1 Identify point people for fall     December 2010    List of point persons   ODA and AAA’s       Current funding
sustainability by    prevention at each Area Agency on                         will be provided and                        and in-kind
identifying local    Aging Region.                                             shared
champions for this
work.
                     2.2.2 Identify county-specific           December 2010    List of champions       ODH, AAAs,          Current funding
                     champions for fall prevention efforts.                    will be provided and    EMAs, local         and in-kind
                                                                               shared                  coalitions, local
                                                                                                       senior centers,
                                                                                                       and others

Older Adult Falls Prevention Coalition Goals and Objectives                                                                        Page 11
Older Adults
                    2.2.3 Institutionalize funding            From 2010-2014   Funding Committee      Coalition       Additional
                    mechanisms for maintaining efforts to                      to be formed; grant    members and     funding
                    support fall prevention efforts at the                     applications will be   other           will be needed
                    state and local level.                                     submitted;             organizations   in various
                                                                               legislative funding    identif ied     venues and for
                                                                               will be considered                     various
                                                                                                                      populations and
                                                                                                                      partner efforts




Older Adult Falls Prevention Coalition Goals and Objectives                                                                   Page 12
Older Adults
         Goal 3: Policy

              1. To provide information to organizational, local and state leaders resulting in legislation,
                 regulations, and policies that address falls prevention interventions.

Objectives             Activities                             Implementation     Expected               Partners         Funding
                                                              Timeframe          Outcomes                                Implications

1.1 Develop falls      1.1.1. Assemble falls advocacy         From 2010 – 2011   Advocacy group         Selected         Current funding
prevention agenda.     group.                                                    identif ied            Coalition
                                                                                                        member
                                                                                                        organizations



                       1.1.2. Identify and prioritize falls   From 2010 – 2014   Propose policy         All Coalition    Current funding
                       issues annually that could be                             initiatives and/or     member           to propose;
                       addressed by policy initiatives.                          support them           organizations    possible
                                                                                                        and others to    additional
                                                                                                        be identif ied   funding to
                                                                                                                         implement



                       1.1.3 Identify local champions.        From 2010 – 2011   List of local          All Coalition    Current funding
                                                                                 champions we can       member
                                                                                 contact for support    organizations
                                                                                                        and others to
                                                                                                        be identif ied



                       1.1.4 Charge falls policy advocacy     From 2010 – 2014   Log of phone calls,    All Coalition    Current funding
                       group participants with advocating                        e-mails, releases      member           or software
                       through his/her                                           pertaining to policy   organizations    update funds
                       agency/organization, etc.                                 advocacy               and others to
                                                                                                        be identif ied


Older Adult Falls Prevention Coalition Goals and Objectives                                                                      Page 13
Older Adults
                        1.1.5 Draft annual policy advocacy    From 2010 - 2014   Annual white papers      Coalition Work   Current funding
                        agenda in the form of a “white                           are produced and         Groups and
                        paper” in conjunction with needs                         shared                   other
                        and resource assessments and                                                      constituents
                        overall OIPP policy initiatives.




1.2 Annually            1.2.1 Identify current rules,         From 2010 – 2014   Key legislation          All Coalition    Funding needed
compile federal,        regulations, ordinances, etc. that                       identif ied, and         member           to staff this
state and local         support or are contrary to falls                         addressed through        organizations    activity and
statutes, etc.          prevention tenets.                                       action steps             and Policy       perform follow-
                                                                                                          Advocacy Group   up



                        1.2.2 Identify proposed legislation   From 2010 – 2014   Proposed legislation     All Coalition    Funding needed
                        currently being considered.                              identif ied; Coalition   member           to staff this
                                                                                 involved in review       organizations    activity and
                                                                                 and recommends           and Policy       perform follow-
                                                                                 action steps             Advocacy Group   up



                        1.2.3 Identify key legislation        From 2010 - 2014   Proposed legislation     All Coalition    Funding needed
                        for consideration in Ohio.                               identif ied; Coalition   member           to staff this
                                                                                 involved in review       organizations    activity and
                                                                                 and recommends           and Policy       perform follow-
                                                                                 action steps             Advocacy Group   up



1.3 Develop             1.3.1 Identify stakeholders at        From 2010 – 2014   List of stakeholders     ODH, ODA,        Current funding
strategies for          federal, state and local levels.                         and legislators to be    OPHA, other
approaching                                                                      contacted                Coalition
legislators and other                                                                                     organizations
stakeholders.

Older Adult Falls Prevention Coalition Goals and Objectives                                                                        Page 14
Older Adults
                       1.3.2 Identify supporters/              From 2010 – 2014   Supporters             ODH, ODA,         Current funding
                       adversaries of mandates.                                   identif ied and        OPHA, other
                                                                                  detractors educated    Coalition
                                                                                                         organizations



                       1.3.3 Develop key messages              From 2010 – 2014   Educational            ODH, ODA,         Funding needed
                       regarding falls to address                                 materials and data     OPHA, other       to staff this
                       legislators/policy makers.                                 developed for policy   Coalition         activity and
                                                                                  use                    organizations     develop
                                                                                                                           materials and
                                                                                                                           keep them
                                                                                                                           current and
                                                                                                                           locally pertinent



                       1.3.4. Provide/develop                  From 2010 – 2014   Recommendations        ODH, ODA,         Funding needed
                       recommendations to                                         included in annual     OPHA, other       to staff this
                       legislators/policy makers.                                 white papers are       Coalition         activity and to
                                                                                  included in state      organizations     monitor
                                                                                  and local policies                       outcomes



                       1.3.5 Meet with stakeholders on         From 2010 – 2014   At least 6 meetings    Policy Advocacy   Funding to
                       their own turf, etc. to discuss falls                      or contacts are held   group             support travel
                       prevention.                                                per year               members,          expenses and
                                                                                                         Coalition         possibly staff
                                                                                                         members and
                                                                                                         identif ied
                                                                                                         champions



                       1.3.6 Create messages that public       From 2010 - 2014   Advocacy messages      Policy Advocacy   Current funding
                       can use to advocate with                                   and materials          Group and


Older Adult Falls Prevention Coalition Goals and Objectives                                                                         Page 15
Older Adults
                        stakeholders.                                            developed and          other Coalition
                                                                                 updated annually       members



1.4 Educate public      1.4.1. Develop public relations       From 2010 – 2014   Media materials will   ODA, ODH,           Funding to
sector, key             program that incorporates social                         be developed and       OPHA                produce media
organizations and       marketing concepts/principles.                           shared                                     materials and
stakeholders about                                                                                                          public education
falls.                                                                                                                      items



                        1.4.2 Conduct trainings at            From 2010 – 2014   Conduct a minimum      Policy Advocacy     Funding needed
                        appropriate public/private clubs,                        of 10 events per       Group and/or        to support travel
                        organizations, etc.                                      year                   other Coalition     expenses,
                                                                                                        members, ODH,       material
                                                                                                        ODA, OPHA           development,
                                                                                                                            etc.



                        1.4.3 Invite legislators/             From 2011 - 2014   List of legislators    Policy Advocacy     Funding needed
                        stakeholders to regional falls                           and other              Group and/or        for
                        prevention education events.                             stakeholders invited   other Coalition     space/logistics
                                                                                 and attending          members, ODH,       and materials
                                                                                 various Coalition      ODA, OPHA           and speaker fees
                                                                                 events                                     for these events




1.5 Promote state       1.5.1 Create framework for            From 2010 – 2014   Number of local        Advocacy Group      Funding needed
wide advocacy           local/community organizations.                           communities that       and other           for media time
initiatives driven by                                                            adopted some fall      Coalition           and advertising
falls state advocacy                                                             initiatives as         member
group.                                                                           recommended by         organizations;
                                                                                 advocacy group         engage public
                                                                                                        relations offices
                                                                                                        of ODA/ODH

Older Adult Falls Prevention Coalition Goals and Objectives                                                                         Page 16
Older Adults
                       1.5.2 Act as a resource for            From 2010 - 2014   Maintain online         Policy Advocacy   Current funding
                       local/community organizations.                            toolkit materials and   Group
                                                                                 log contacts from
                                                                                 local organization
                                                                                 and/or public;



1.6 Propose at least   1.6.1 Identify potential policy        By 12/31/2014      Proposed legislation    Policy Advocacy   Current funding
one fall prevention    issues that could be addressed by                         is assigned a Senate    Group, OPHA       to support
related legislation    legislation                                               or House Bill                             promotion of
policy to be                                                                     number with                               legislation
considered for                                                                   bipartisan
adoption.                                                                        sponsorship




Older Adult Falls Prevention Coalition Goals and Objectives                                                                        Page 17
Older Adults
         Goal 4: Interventions/Risk Assessment

         1. To create an easy and accessible tool box for health care providers, older adults and caregivers
            to utilize in order to reduce the risk of falls.

Objectives             Activities                              Implementation    Expected               Partners        Funding
                                                               Timeframe         Outcomes                               Implications
1. 1 Provide           1.1.1 Develop or identify risk          From 2010-2011    Tool kit of various    All Coalition   Current funding
information for        assessment and intervention tools.                        risk assessment        members and     and in-kind
health care                                                                      screening items        other           resources
providers                                                                        will be available      identif ied
                                                                                                        associations



                       1.1.2 Develop or identify resource      From 2011-2012    Guides will be         All Coalition   Current funding
                       guide of intervention and risk                            available with         members and     and in-kind
                       assessment tools.                                         information specific   others as       resources
                                                                                 to various areas of    identif ied
                                                                                 the state



                       1.1.3 Provide information on training   From 2010- 2014   Training and           All Coalition   Funding may be
                       opportunities for best practices.                         Continuing             members and     required to
                                                                                 Education              others as       provide some
                                                                                 opportunities will     identif ied     trainings by the
                                                                                 be included in                         Coalition
                                                                                 organization
                                                                                 annual meetings;
                                                                                 announced in
                                                                                 newsletters and
                                                                                 journals; posted on
                                                                                 website calendars




Older Adult Falls Prevention Coalition Goals and Objectives                                                                       Page 18
Older Adults
1.2 Provide            1.2.1. Develop or identify and          From 2010-2013   Materials identif ied   All Coalition    Current funding
information for        distribute self-use risk assessments                     and disseminated;       members and      and in-kind
Client/Caregivers      such as home and medicine                                posted to websites;     others as        resources
                       assessments; as well as intervention                     printed as needed       identif ied
                       services.



                       1.2.2. Identify places/businesses       From 2010-2013   Business partners       All Coalition    Current funding
                       that can assist in distributing these                    identif ied,            members &        and in-kind
                       items, in addition to web resources.                     promoted and            businesses       resources
                                                                                recognized; items       identif ied
                                                                                posted to websites



                       1.2.3. Develop or identify and          From 2010-2014   Guides developed        All Coalition    Funding may be
                       distribute risk and intervention                         including               members and      needed to print
                       resource guide for public use.                           information specific    other partners   materials for
                                                                                to various areas of     as identified    public use
                                                                                the state; posted
                                                                                to websites; shared
                                                                                with business
                                                                                partners



1.3 Provide            1.3.1 Assure that risk assessment       From 2011-2014   Risk assessment         All Coalition    Funding w ill be
information for the    and intervention resources are                           and intervention        members,         needed or
general public         included in public education                             resources will be       media partners   leveraged to fully
                       campaign materials to be developed.                      included in public      and other        implement this
                                                                                education and           partners as      activity
                                                                                social marketing        identif ied
                                                                                campaign materials




Older Adult Falls Prevention Coalition Goals and Objectives                                                                        Page 19
Older Adults
         Goal 5. Monitoring Trends for Fall-Related Data

       1. To capture quality falls-related data in order to monitor trends.


Objectives           Activities                               Implementation     Expected                 Partners           Funding
                                                              Timeline           Outcomes                                    Implications

1.1 Partner to       1.1.1 Inventory current sources of       From 2010 – 2011   Fall data sources will   ODH Injury         Current Funding
assess the quality   injury data in Ohio (death, risk                            be identif ied and       Program, ODA,
of existing data     factor, fatality review, ED and                             published                OIPP Data
sources and          inpatient hospital, EMS, Trauma,                                                     Action Group
opportunities for    crime, traffic crash, poison control,
linkage, etc.        brain injury, etc .) for reporting
                     information about injuries fro m
                     falls and fall risk factors.



                     1.1.2 Produce recommendations            From 2011 – 2012   Printed list of          ODH Injury         Current Funding
                     about the inclusion in injury-related                       recommended              Program, ODH
                     or fall-related questions on                                questions to be          Division of
                     behavior risk surveys,                                      included in patient      Quality,
                     hospital/nursing home/assisted                              assessments              Coalition
                     living forms, physician office intake                                                member
                     forms and EMS guidance                                                               organizations,
                     documents, etc.                                                                      local c oalition
                                                                                                          members,
                                                                                                          county
                                                                                                          champions



                     1.1.3 Identify methods to                From 2011 - 2012   Improved quality of      OIPP Data          Current Funding
                     determine the impact of injuries on                         falls data from          Action Group,
                     high-risk groups and communities                            various reporting        ODH Injury


Older Adult Falls Prevention Coalition Goals and Objectives                                                                           Page 20
Older Adults
                     (e.g., YPLL, costs, outcomes).                                  sources               Program,
                                                                                                           Coalition
                                                                                                           member
                                                                                                           organizations,
                                                                                                           local coalitions,
                                                                                                           CDC data
                                                                                                           sources



                     1.1.4 Monitor the implementation         From 2011 and          Improved quality of   ODH Injury          Current Funding
                     of fall prevention reporting             ongoing through 2014   falls data from       Program, ODH
                     recommendations.                                                various reporting     Quality
                                                                                     sources               Division, other
                                                                                                           Coalition
                                                                                                           member
                                                                                                           organizations
                                                                                                           responsible for
                                                                                                           data collec tion,
                                                                                                           nursing homes,
                                                                                                           etc.



1.2 Identify gaps    1.2.1 Survey stakeholde rs/              From 2010 – 2011       Additional data       Coalition           Current Funding
in data/             partners to identify additional data                            elements will be      member
information and      elements needed to better evaluate                              determined and a      organizations,
work to fill them.   trends in falls and fall-related                                summary of the        local health
                     injuries and fatalities.                                        survey will be        depart ments/
                                                                                     produced              coalitions, ODH
                                                                                                           BRFSS,
                                                                                                           Division of
                                                                                                           Quality and
                                                                                                           Injury Program




Older Adult Falls Prevention Coalition Goals and Objectives                                                                             Page 21
Older Adults
                      1.2.2 Determine or develop ways         From 2011 – 2012    Guidance document        ODH Injury         Current Funding
                      to obtain additional data elements                          will be produced,        Program and
                                                                                  new partners or data     Division of
                                                                                  sources identifie d      Quality, other
                                                                                                           partners as
                                                                                                           appropriate

1.3 Establish         1.3.1 Review the existing data and      From 2011 -1 2012   Baselines will be                           Current Funding
baselines.            establish baselines for added                               established and          ODH Injury
                      measures (HP 2020)                                          published for            Program, ODH
                                                                                  existing and added       Quality
                                                                                  measures                 Division, OIPP
                                                                                                           Data Action
                                                                                                           Group, local
                                                                                                           coalitions and
                                                                                                           other data
                                                                                                           source
                                                                                                           partners as
                                                                                                           identif ied

1.4 Partner to        1.4.1 Implement recommendations         Throughout 2011     Guidance document                           Current funding;
improve the           from the MMWR report to improve                             or position paper will   Coalition          may require
quality of external   e-coding in Ohio hospital data.                             be produced to           member             additional funding
cause of injury                                                                   encourage improved       organizations,     for training on e-
coding (e-coding)                                                                 use of e-coding          ODH Injury         coding related to
in hospital and                                                                                            Program and        fall data
discharge data.                                                                                            local coalitions

                      1.4.2 Provide procedure guidelines      From 2011-2013      Guidance document                           Current funding;
                      for continuous quality improvement                          will be produced for     Ohio Hospital      may require
                      once e-coding is in place                                   distribution             Association,       additional funding
                                                                                                           Hospital RHIT      for training
                                                                                                           Association,
                                                                                                           ODH Injury


Older Adult Falls Prevention Coalition Goals and Objectives                                                                             Page 22
Older Adults
                                                                                                        Program,
                                                                                                        ODPS, OIPP
                                                                                                        Data Work
                                                                                                        Group

                     1.4.3 Provide data, standards and        From 2013-2014     Increase the                           Additional funding
                     training to clinicians, coders and                          proportion of injury   Ohio Hospital   may be required
                     administrators for improving the                            discharges that are    Association,    for training
                     recording of injury circumstance                            e-coded                Hospital RHIT
                     information in medical records.                                                    Association,
                                                                                                        ODH Injury
                                                                                                        Program,
                                                                                                        ODPS, OIPP
                                                                                                        Data Work
                                                                                                        Group

                     1.4.4 Produce reports for clinicians     2014 and ongoing   Increase the                           Current funding,
                     and coders to demonstrate the                               proportion of injury   Ohio Hospital   may require
                     value of their efforts.                                     discharges that are    Association,    additional funding
                                                                                 e-coded                Hospital RHIT   for distribution
                                                                                                        Association,
                                                                                                        ODH Injury
                                                                                                        Program,
                                                                                                        ODPS, OIPP
                                                                                                        Data Work
                                                                                                        Group




Older Adult Falls Prevention Coalition Goals and Objectives                                                                       Page 23
Older Adults
         2. Develop mechanisms to make the data more accessible and user friendly.

2.1 Increase the     2.1.1 Produce reports/fact sheets        From 2011 and   Reports/Fact sheets    All Coalition   Current and in-
availability of      on the injury and fall priority areas.   ongoing         produced annually      members         kind funding
statewide and
community-
specific data for    2.1.2 Develop multiple methods of        From 2011 and   Amount and method      All Coalition   Current funding
planning,            dissemination to enhance the             ongoing         of dissemination is    members
surveillance, and    timeliness and accessibility.                            captured in
evaluation.                                                                   database


                                                                                                                     In-kind w ith
                     2.1.3. Explore ways to promote           From 2010 and   Proposal for web-      All Coalition   pursuit of
                     access to web-based data                 ongoing         based data resource    Members         additional funding
                     resources, especially to                                 is produced and list
                     underserved communities.                                 of potential funding
                                                                              sources produced




2.2 Review data      2.2.1 Updated burden of falls            By 2013         Report is produced     All Coalition   Additional funding
and report trends    report produced                                          and publicized         Members         may be required
every five years.




Older Adult Falls Prevention Coalition Goals and Objectives                                                                   Page 24
Older Adults
         Evidence-based Interventions and Resources

Prevention of Falls Among Older Adults – Multi-Factorial Interventions

Effective fall prevention programs for older adults include the following components:
     Medical Management (Risk Assessment by a Health Professional)
     Balance and Mobility (Physical Activity)
     Environmental resources provide information on evidence-based fall prevention programs.

CDC Fall Prevention Activities
http://www.cdc.gov/ncipc/duip/FallsPreventionActivity.htm

http://www.cdc.gov/ncipc/preventingfalls/

Preventing Falls: What Works A CDC Compendium of Effective Community-based Interventions from Around the
World – This compendium, designed for public health practitioners and community-based organizations, describes 14
scientifically tested and proven interventions.

http://www.cdc.gov/ncipc/preventingfalls/CDCCompendium_030508.pdf

Preventing Falls: How to Develop Community-based Fall Prevention Programs for Older Adults

This “how-to” guide is designed for community-based organizations that are interested in developing their own effective fall
prevention programs.

http://www.cdc.gov/ncipc/preventingfalls/CDC_Guide.pdf

National Council on Aging – Center for Healthy Aging – Fall Prevention

http://www.healthyagingprograms.org/content.asp?sectionid=98




Older Adult Falls Prevention Coalition Goals and Objectives                                                                Page 25
Older Adults
            Contributors

NAME                                      AGENCY
Susan Sutherland, RS                      Delaware General Health District
Lois Hall, MS                             Ohio Public Health Association
Diane Ramey                               Area Agency on Aging, Region 5
Vicky Abdella                             Area Agency on Aging, Region 7
Vicky Woyan                               Area Agency on Aging, Region 7
David Painter                             Arthritis Foundation, Central Ohio Chapter
Suzanne Minnich                           Brain Injury Association of Ohio
Jane Acri, LSW                            Central Ohio Area Agency on Aging
Jeanne Grothaus                           Central Ohio Diabetes Association
Dan Davis                                 Central Ohio Parkinson Society
Denise Franer                             Clermont County Health District
Lea Blackburn, LISW, ACSW                 Community Partnerships, Columbus
Fara Waugh, LISW-S                        Council for Older Adults of Delaware County, Center for Older Adults
Vince Caraffi                             Cuyahoga County Board of Health
Anne Goodman, MPH                         Delaware General Health District
Sheila Faryman, MD                        Department of Medical Education, John J Gerlach Center
Teri Moore                                Franklin County Office on Aging
Amy Wermert, MPH                          Grant Medical Center, Trauma Program, Columbus
Ana Rojas Moonitz                         Hamilton County HD
Mary Jo McGuire, MS, OTR/L, OTPP, FAOTA   Home and Community Services, The Rehabilitation and Health Center, Akron
Christy Beeghly, MPH                      Injury Prevention Program, Ohio Department of Health
Cindy Penn                                Injury Prevention Program, Ohio Department of Health
Kathy Papp, RN, MSN                       LifeCare Alliance, Columbus
Regina Rambo                              Mercy St Vincent’s Medical Center, Toledo
Virginia Winenger                         Mt Carmel East
Melinda Deacon                            Ohio Assisted Living Association
Jean Thompson                             Ohio Assisted Living Association
Beth Foster, RN, BA, CPHQ                 Ohio Council for Home Care and Hospice
Sande Johnson                             Ohio Department of Aging
Dick LeBlanc                              Ohio Department of Aging
Cathy Stocksdale                          Ohio Department of Aging, Quality Assurance/Quality Improvement
Tim Erskine                               Ohio Department of Public Safety
Joe Sabino                                Ohio Pharmacists Association
Jamie Weaver                              Ohio Public Health Association
Michele Stokes, PhDc, MS                  OhioHealth Gerlach Center for Senior Health, Columbus
Michelle Thomas, PT, DPT                  OhioHealth Neighborhood Care, Columbus
Theresa Jeffers, BS, CHES                 OSU Medical Center, Trauma Program
Ann Smith, PhD, RN, CRA, ANP              OSUMC-Trauma Clinic
Julie McCarthy                            Partners in Prime, Hamilton
Kira Baldonado                            Prevent Blindness
Dara Bakes, BS, EMT-P                     Riverside Methodist Hospital, Columbus
Elizabeth Baum, MD, CMD                   SUMMA Health Systems, Akron
Kristin Beadle, DPT                       The Balance and Mobility Clinic of Columbus
Deanna Montanaro                          The University of Toledo Medical Center
Arvind Modawal, MD, MPH                   University of Cincinnati Medical Center
Kimberly Bigelow, PhD                     University of Dayton
Ben Anders                                Upper Arlington Fire Division, Office of EMS & Training
Lynne O’Neil                              Wood County Committee on Aging
Lolita Haverlock                          YMCA, Liberty Township, Powell
                                          Alzheimer’s Association, Central Ohio Chapter




Older Adult Falls Prevention Coalition Goals and Objectives                                                          Page 26
Older Adults
References




1
  Hornbrook MC, Stevens VJ, Wingfield DJ, Hollis JF, Greenlick MR, Ory MG. Preventing falls among community-dwelling older persons: results from a
randomized trial. Gerontologist 1994; 34(1):16–23.
2
  Ohio Department of Health. The Burden of Injury from Unintentional Falls in Ohio; 2002 -2005.
http://www.healthyohioprogram.org/diseaseprevention/fallsrept.aspx
3
  Ohio Department of Health. The Burden of Injury from Unintentional Falls in Ohio; 2002 -2005.
http://www.healthyohioprogram.org/diseaseprevention/fallsrept.aspx
4
  Ohio Department of Health. The Burden of Injury from Unintentional Falls in Ohio; 2002-2005.
http://www.healthyohioprogram.org/diseaseprevention/fallsrept.aspx
5
  Ohio Department of Health. The Burden of Injury from Unintentional Falls in Ohio; 2002 -2005.
http://www.healthyohioprogram.org/diseaseprevention/fallsrept.aspx
6
  Ohio Department of Health. The Burden of Injury from Unintentional Falls in Ohio; 2002 -2005.
http://www.healthyohioprogram.org/diseaseprevention/fallsrept.aspx
7
  Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention 2006;12:290–5.
8
  Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age and Ageing 1997;26:189–193.




Older Adult Falls Prevention Coalition Goals and Objectives                                                                                          Page 27
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