Frequent 911 Fall Calls in Older Adults: Opportunity for Injury Prevention Strategies

Quatman, Carmen E.; Anderson, Jeffrey P.; Mondor, Michael; Halweg, Jodi; Quatman‐Yates, Catherine; Switzer, Julie A.

doi:10.1111/jgs.15457

Cited by 15 publications

(14 citation statements)

References 34 publications

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“…Deployment of EMS for lift assists diverts care from high acuity emergencies and can cost a single community millions of dollars in lost revenue 24 . High 9‐1‐1 utilizers are common with 43% of repeat callers calling ≥3 times and 1% calling EMS ≥10 times after an initial fall call 24 . Alarmingly, over 60% of older adults who use EMS for a lift assist die or have additional emergency visits within 6 months 12 .…”

Section: Discussionmentioning

confidence: 99%

Automated referral to community paramedicine during 9‐1‐1 fall calls for resource activation

Quatman

Wiseman

Sheridan

et al. 2022

J American Geriatrics Society

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Background: We sought to improve the referral process to a community paramedicine (CP) program following a 9-1-1 encounter.Methods: An electronic health record (EHR) for CP records with the ability to link to emergency EHR was identified and implemented with a single-click referral to the CP program. Referrals were tracked for 15 months before and after implementation.Results: Referral capacity increased from an average of 14.2 referrals per month to 44.9 referrals per month. Conclusion:The results of this study suggest an EHR is a useful investment for CP programs and may be integral to efficient program operations.

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Section: Discussionmentioning

confidence: 99%

Automated referral to community paramedicine during 9‐1‐1 fall calls for resource activation

Quatman

Wiseman

Sheridan

et al. 2022

J American Geriatrics Society

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“…Fourth, EMS providers who are called to older adults’ homes to provide lift assists are in a prime position to assess further fall risk and provide education and brief interventions to prevent these older adults from falling again [23]. The ED is also a logical place for multifactorial fall risk assessment and brief interventions for older adults with fall injuries.…”

Section: Discussionmentioning

confidence: 99%

Fall-related emergency department visits and hospitalizations among community-dwelling older adults: examination of health problems and injury characteristics

Choi

DiNitto

et al. 2019

BMC Geriatr

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BackgroundFall injuries and related healthcare use among older adults are increasing in the United States. This study examined chronic illnesses, sensory and memory problems, and injury characteristics that were associated with ED visits and hospitalizations among older adults who received medical attention for fall injuries within a 91-day reference period.MethodsData were from the publicly available 2013–2017 US National Health Interview Survey files (unweighted N = 1840 respondents aged > 60 years with fall injuries). We first described socioeconomic, health/mental health, healthcare utilization, and injury characteristics among three groups: those who neither visited an ED nor were hospitalized for their fall injury, those who visited an ED only, and those who were hospitalized. Then, using multinomial logistic regression analysis, we examined associations of healthcare utilization (ED visit only and hospitalization vs. no ED visit/hospitalization) with chronic illnesses, other health problems, and injury characteristics, controlling for socioeconomic factors.ResultsOf older adults who received medical attention for fall injuries, a little more than one-third had an ED visit only and a little less than a fifth had an overnight hospital stay. Multivariable analysis showed that lung disease and memory problems were associated with higher risk of ED visit only; hip and head injuries, facial injuries, and broken bones/fractures (from any type of injury) were more likely to result in hospitalization than other injuries. Fall injuries sustained inside the home, falls from loss of balance/dizziness, and living alone were also more likely to result in hospitalization.ConclusionsThese healthcare utilization findings indicate the significant toll that fall injuries exact on older adults and healthcare systems. Fall prevention should target risk factors that are specific to serious injuries requiring costly care. Strategies for implementing scalable, adaptable, and measurable fall prevention models by primary care and emergency medical service providers and ED staff are needed.

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“…They therefore aim to reconfigure their role to enable them to engage in (and be reimbursed for) chronic disease management, preventive care, and postdischarge follow-up visits. 27,28,[36][37][38][39] Forging partnerships with senior housing providers fits well with an EMS approach emphasizing community health.…”

Section: What This Study Addsmentioning

confidence: 98%

“…It can also result from preventable health issues: poorly managed medications, 24 for example, or unsafe living environments. 25,26 EMS providers also frequently respond to calls that do not result in ED transfers: the prime example is "lift assists," when EMS providers are called to help older adults get up after falling; calls of this type can indicate broader, intensifying health care needs [27][28][29][30] and represent a significant amount of EMS business; one study found that 21% of falls-related EMS trips for older adults did not result in an ED transfer; 28 one small study found the 5% of all EMS calls were lift-assists. 27 Because such calls are uncompensated by insurance, EMS providers are motivated to support efforts to reduce their frequency.…”

Section: Introductionmentioning

confidence: 99%

The impact of health‐related supports in senior housing on ambulance transfers and visits to emergency departments: The Right Care, Right Place, Right Time Project

Nadash

Cohen

Tavares

et al. 2021

Health Services Research

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Objective: To test the impact of placing a wellness team (nurse and social worker) in senior housing on ambulance transfers and visits to emergency departments over 18 months. Data sources/study setting: Intervention sites included seven Boston-area buildings, with five buildings at comparable settings acting as controls. Data derive from building-level ambulance data from emergency responders; building-level Medicare claims data on emergency department utilization; and individual-level baseline assessment data from participants in the intervention (n = 353) and control (n = 208) sites. Study design: We used a pre/postdifference in difference quasi-experimental design applying several analytic methods. The preintervention period was January 2016-March 2017, while the intervention period was July 2017-December 2018. Data collection/extraction methods: Emergency responders provided aggregate transfer data on a daily basis for intervention and control buildings; the Quality Improvement Organization provided quarterly aggregate data on emergency department visit rates; and assessment data came from a modified Vitalize 360 assessment and coaching tool. Principal findings:The study found an 18.2% statistically significant decline in ambulance transfers in intervention buildings, with greater declines in buildings that had fewer services available at baseline, compared to other intervention sites. Analysis of Medicare claims data, adjusted for the proportion of residents over 75 per building, found fewer visits to emergency departments in intervention buildings.Conclusions: Health-related supports in senior housing sites can be effective in reducing emergency transfers and visits to emergency departments.

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Frequent 911 Fall Calls in Older Adults: Opportunity for Injury Prevention Strategies

Cited by 15 publications

References 34 publications

Automated referral to community paramedicine during 9‐1‐1 fall calls for resource activation

Automated referral to community paramedicine during 9‐1‐1 fall calls for resource activation

Fall-related emergency department visits and hospitalizations among community-dwelling older adults: examination of health problems and injury characteristics

The impact of health‐related supports in senior housing on ambulance transfers and visits to emergency departments: The Right Care, Right Place, Right Time Project

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