Falls: Screening for Future Fall Risk

Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

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As the leading cause of both fatal and nonfatal injuries for older adults, falls are one of the most common and significant health issues facing people aged 65 years or older (Schneider, Shubert and Harmon, 2010). Moreover, the rate of falls increases with age (Dykes et al., 2010). Older adults are five times more likely to be hospitalized for fall-related injuries than any other cause-related injury. It is estimated that one in every three adults over 65 will fall each year (Centers for Disease Control and Prevention, 2015). In those over age 80, the rate of falls increases to fifty percent (Doherty et al., 2009). Falls are also associated with substantial cost and resource use, approaching $30,000 per fall hospitalization (Woolcott et al., 2011). Identifying at-risk patients is the most important part of management, as applying preventive measures in this vulnerable population can have a profound effect on public health (al-Aama, 2011). Family physicians have a pivotal role in screening older patients for risk of falls, and applying preventive strategies for patients at risk (al-Aama, 2011).

All older persons who are under the care of a heath professional (or their caregivers) should be asked at least once a year about falls. (American Geriatrics Society/British Geriatric Society/American Academy of Orthopaedic Surgeons, 2010)

Older persons who present for medical attention because of a fall, report recurrent falls in the past year, or demonstrate abnormalities of gait and/or balance should have a fall evaluation performed. This evaluation should be performed by a clinician with appropriate skills and experience, which may necessitate referral to a specialist (e.g., geriatrician). (AGS/BGS/AAOS, 2010)

A higher score indicates better quality

Reference Type: CITATION

Reference Text: 'al-Aama, T. 2011. "Falls in the Elderly: Spectrum and Prevention." Can Fam Physician 57(7),771-6.'

Reference Type: CITATION

Reference Text: 'American Geriatrics Society and British Geriatric Society. (2010) Prevention of Falls in Older Persons Clinical Practice Guidelines. Accessed June 14, 2018. Available at 
https://www.archcare.org/sites/default/files/pdf/2010-prevention-of-falls-in-older-persons-ags-and-bgs-clinical-practice-guideline.pdf'

Reference Type: CITATION

Reference Text: 'Centers for Disease Control and Prevention. 2015. "Important Facts about Falls" (December 14, 2015) http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html'

Reference Type: CITATION

Reference Text: 'Doherty, M., and J. Crossen-Sills. 2009. "Fall Risk: Keep your Patients in Balance." The Nurse Practitioner: The American Journal of Primary Health Care 34(12),46-51.'

Reference Type: CITATION

Reference Text: 'Dykes, P.C., D.L. Carroll DL, A. Hurley A, S. Lipsitz S, A. Benoit A, F. Chang F, S. Meltzer S, R. Tsurikova R, L. Zuyov L, B. Middleton B. 2010. "Fall Prevention in Acute Care Hospitals: A Randomized Trial." JAMA. 2010;304(17),1912-1918.'

Reference Type: CITATION

Reference Text: 'Schneider, E.C., T.E. Shubert, and K.J. Harmon. 2010. "Addressing the Escalating Public Health Issue of Falls Among Older Adults." NC Med J 71(6),547-52.'

Reference Type: CITATION

Reference Text: 'Woolcott, J.C., K.M. Khan, S. Mitrovic, A.H. Anis, C.A. Marra. 2011. "The Cost of Fall Related Presentations to the ED: A Prospective, In-Person, Patient-Tracking Analysis of Health Resource Utilization." Osteporos Int [Epub ahead of print].'

Screening for Future Fall Risk: Assessment of whether an individual has experienced a fall or problems with gait or balance. A specific screening tool is not required for this measure, however potential screening tools include the Morse Fall Scale and the timed Get-Up-And-Go test.

Fall: A sudden, unintentional change in position causing an individual to land at a lower level, on an object, the floor, or the ground, other than as a consequence of sudden onset of paralysis, epileptic seizure, or overwhelming external force.

This eCQM is a patient-based measure.

This version of the eCQM uses QDM version 5.6. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.

TBD

Patients aged 65 years and older at the start of the measurement period with a visit during the measurement period

Equals Initial Population

Exclude patients who are in hospice care for any part of the measurement period

Patients who were screened for future fall risk at least once within the measurement period

Not Applicable

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For every patient evaluated by this measure also identify payer, race, ethnicity and sex

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