INTRODUCTION OF A HOME BASED FALLS MEDICAL ASSESSMENT FALLS SPECIALIST SERVICE PENINSULA HEALTH Vicki Davies Manager Falls Prevention Service

Peninsula Health Falls Clinic Background Multi disciplinary Falls Clinic held twice monthly with a capacity of 3 clients per Clinic Clients may require initial assessment or 3 month medical review Consists of Geriatrician, Physiotherapist and Dietician with pre-Clinic Occupational Therapy home assessment

Falls Clinic Referrals In the 6 month period from September 2004 to March 2005, 139 clients were referred to the Falls Specialist Service for initial assessment (conducted at home) Of those clients 43 required further assessment at the Falls Clinic (31%)

Analysis of Falls Clinic Waiting List In March 2005, 28 clients were on the Falls Clinic waiting list for initial assessment with an additional 4 requiring medical review 6 had been waiting 3 months or less (21%) 18 had been waiting between 3 and 6 months (64%) 4 had been waiting greater then 6 months (14%)

Proposed Strategies for Reducing Falls Clinic Waiting List Introduce a second Falls Clinic – but need to consider availability of venue and availability and cost of Geriatrician and Allied Health staff Conduct medical reviews separate to Falls Clinic – but only a small number of these Introduce a home based medical assessment

Implementation of Home Based Medical Assessments Developed selection criteria – frail, no access to transport, no significant Physio needs Collaborated with Dept Aged Care Medicine to release Doctor for one session per week Falls Care Coordinator accompanied Doctor Vehicle supplied via Hospital car pool Admin support provided by Falls Service

Review of Recommendations Made In 12 week period following implementation 20 assessments were conducted Major recommendations made were: Further medical investigation by LMO (60%) Community strengthening program (40%) Centre based Physiotherapy (20%) Increased/changed use of gait aid (15%) Inpatient rehabilitation (15%)

Feedback Sought From Clients 45% response rate 100% happy with the way assessment was conducted 89% received adequate feedback on Doctor’s recommendations 78% preferred home based assessment to clinic based

Feedback Sought From LMO’s 56% response rate 89% aware assessment had been conducted 67% received adequate feedback 89% happy for Falls Care Coordinator to decide on location of medical assessment (home based versus Falls Clinic)

Summary Home based medical assessments provided a cost effective option to reduce Falls Clinic waiting list Provided more accessible and equitable services for frail or housebound clients Majority of clients and LMO’s were happy with the service Could only be achieved through collaboration of Falls Prevention Service and Aged Care Medicine