Falls assessment and prevention in older people: an evaluation of the Crisis Response Service

Abstract

The elderly population of the world is growing with increasing trends of older people falling and accessing emergency services. The Crisis Response Falls Service in Northamptonshire (UK) was designed to identify health and social care needs, promote independence and limit the impact of falls. This paper presents the findings of an evaluation of the service. A mixed-method approach was applied, drawing on the views of service users (via a survey and telephone interviews) and reviewing existing East Midlands Ambulance Service (EMAS) data with routinely collected data from the service.A decrease in the numbers of patients conveyed to hospital following a fall was observed. Best estimates of financial calculations suggest savings. High levels of patient satisfaction were achieved; patients felt treated with dignity and staff were considered friendly, approachable and well-informed. First responder services can provide positive impacts for those who fall in the community. The development and impact of the CRS shows the importance of evidence-based client centred training to inform the approaches taken to supporting those who fall, and the impact of a strong values based approach on the experiences of patients. KeywordsParamedic, falls, elderly, patient experience, patient satisfaction, allied health personnel. Key points1) The elderly population of the world is growing with increasing trends of older people falling and accessing emergency services.2) Falls have a range of impacts for communities and individuals, including fractures, traumatic brain injury, hospitalisation or premature death.3) Having an understanding of falls and the circumstances leading to them is invaluable for identifying a targeted, proactive response from commissioners and front line staff.4) It is important that the views of older people are taken into account and that they are afforded choices in interventions, ensuring that they maintain independence and competence.5) This study has begun to illustrate the range of impacts that interagency collaboration can have in supporting older people who fall, alongside the importance of effective training and a values based approach.3

Prevention and management of skin tears in older people

“…Falls prevention schemes have been seen to contribute to preserving both patients' independence and dignity (Pyer et al 2015).…”

A paramedic’s role in reducing number of falls and fall-related emergency service use by over 65s: a systematic review

“…For example, the financial implications of establishing a new care pathway compared to the cost of the traditional route, involving conveyance of all patients to the local emergency department, have been investigated to identify the long-term sustainability of the option ( Snooks et al, 2014 ). Qualitative research can also be found and shows positive responses when exploring the attitudes and opinions of both patients and paramedics on how this option is working ( Pyer et al, 2015 ). Systematic reviews have been published on this topic; however, a gap in the research exists when looking at the effect on subsequent falls and emergency service use from a quantitative perspective as the management of these patients has developed since publication of the latest relevant review ( Zozula et al, 2016 ).…”