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

2. 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

3. 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%)

4. 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%)

5. 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

6. 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

7. 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%)

8. 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

9. 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)

10. 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