In Canada, falls are a top reason for injury-related death, hospitalization and emergency department (ED) visits for older adults. In the North West, falls among older adults account for 40% of hospitalizations; in Thunder Bay alone, they account for 24% of ED visits.

As rehabilitative care is shown to reduce the risk of falls and functional decline in older adults, a team of Thunder Bay health service providers recently piloted the Rehab Care Alliance (RCA)’s post-fall pathways for patients presenting to the ED or to a retirement home’s nurse-led outreach team (NLOT). Pilot participants were older adults who reported a fall but did not require an acute care admission.

Using a quality improvement approach, the team embedded the RCA pathways into practice, guiding clinicians to navigate to the most appropriate rehabilitation service for the older adults who had experienced a fall. Patient demographics, assessment processes, referrals, progress, health status and experience were tracked during three plan-do-study-act (PDSA) cycles.  Partners met at the end of each three-month cycle to review the data analysis, share experiential learnings, and develop an action plan for the next PDSA cycle.

At the end of the pilot, data showed that using this approach to embed an actionable, easy-to-follow rehabilitation post-fall pathway in clinical practice contributed to improved patient function.  Key findings included:

  • The vast majority of patients reported improved function and health-related quality of life.
  • Patients were more likely to recommend the services they received.
  • Process improvements were realized, including the consistent assessment of fall risk factors and rehabilitation follow-up.

Action plans for the Thunder Bay team will address some of the barriers to accessing rehabilitative care. As a next step, the team will also participate in a pilot of the RCA’s Paramedic Post-Fall Pathway.

For more information, or to discuss implementing post-fall pathways in your area, please contact Gabrielle Sadler, Project Manager.