The evaluation of a Fall Management Program in a personal care home (PCH) population
Burland, Elaine M.J.
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Injurious falls are a common problem among older institutionalized adults, having serious physical, psychological and/or financial consequences for the fallers, their families, and personal care home (PCH) staff (Tideiksaar, 2002). North Eastman Health Association (NEHA) introduced a Fall Management Program into its five PCHs in 2005 in an effort to keep residents active and mobile, while minimizing injuries if they fell. The purpose of this research was to evaluate the Fall Management Program to determine if its goals of increased resident mobility and injury minimization were being met. A quasi-experimental, pre-post, comparison group design triangulating different data sources was used to evaluate the effectiveness of the program. Fall Occurrence Report data were collected from all five NEHA PCHs, and from seven similar PCHs in the Interlake Regional Health Authority (IRHA) that did not have a fall program in place. Administrative data from the Manitoba Centre for Health Policy (MCHP) were also used to provide information about some explanatory variables. Comparisons were made between regional health authorities (RHAs) and over time, from the pre- to post- period. Results indicate that NEHA’s Fall Management Program had some benefits for residents – there was a trend towards an increase in mobility (i.e., a non-significant upward trend in falls) while overall injuries remained stable, and falls resulting in hospitalization decreased significantly. NEHA residents appear to have been protected from an increase in injuries despite an upward trend in falls. Moreover, NEHA’s residents had significantly better outcomes compared to similar residents in the non-program PCHs in IRHA. By the post-period, both RHAs had the same rate of falls, but NEHA had significantly fewer injurious falls and falls resulting in hospitalization than IRHA. This suggests that the non-program PCHs had more difficulty preventing resident injuries than the program PCHs in NEHA.