Attending times for seniors
Health care operations analysis to reduce attending times for seniors presenting to the emergency department with a fall.
Project Goals - What are we doing?
Because Emergency Department congestion is a serious health service issue, we designed this study to ask "What are the steps taken to evaluate elderly seniors presenting to the emergency department after a fall and how can this be made more efficient? This collaborative (Emergency Room, health authority decision-makers, health services researchers) study will provide crucial health system data regarding the flow of senior fallers through the Emergency Department and the reasons for its variability. We will also develop a simulation model to aid in developing intereventions to improve this process. We will measure the cost burden of senior fallers in the Emergency Department.
Research Outcomes - What will be achieved?
This project will lead to better understanding of the true extent of senior falls in the Emergency Department setting, the economic cost, and the proportion of patients who receive health services to prevent future falls. The goal is to improve Emergency Department flow-through and to improve delivery of health services to Senior Fallers. Our project has the potential to influence Emergency Department care in other parts of the province as there may be consistent patters in all, or at least large urban, Emergency Departments.
Background - Why is this research important?
Emergency Departments report that they are operating "at" or "over" critical capacity. The BC Ministry of Health has identified that improving access to Emergency Department care, by shortening patient wait times, is a key performance indicator for the Ministry of Health Services. Vancouver Coastal Health Authority, the primary Authority partner in this grant, has listed Emergency Department wait times as an area of priority. Senior fallers utilize 7% of Emergency Department beds. British Columbians aged 70 years or more, who suffer falls and injurious falls (which includes head injuries, fractures and other trauma) require over $180 million in direct health care costs. The addition of indirect costst would greatly increase this estimate.
Back to Knowledge Translation: Selected Projects
Publications related to this project
- Salter AE, Khan KM, Donaldson MG, Davis JC, Buchanan J, Abu-Laban RB, Cook WL, Lord SR, McKay HA. Community-dwelling seniors who present to the emergency department with a fall do not receive Guideline care and their fall risk profile worsens significantly: a 6-month prospective study. Osteoporos Int. 2006;17(5):672-83.
- Donaldson MG, Khan KM, Davis JC, Salter AE, Buchanan J, McKnight D, Janssen PA, Bell M, McKay HA. Emergency department fall-related presentations do not trigger fall risk assessment: a gap in care of high-risk outpatient fallers. Arch Gerontol Geriatr. 2005 Nov-Dec;41(3):311-7.
Suggested readings
- Lee JS, Hurley MJ, Carew D, Fisher R, Kiss A, Drummond N. A Randomized Clinical Trial to Assess the Impact on an Emergency Response System on Anxiety and Health Care Use among Older Emergency Patients after a Fall. Acad Emerg Med. 2007 Mar 1
- Russell MA, Hill KD, Blackberry I, Day LL, Dharmage SC. Falls risk and functional decline in older fallers discharged directly from emergency departments. J Gerontol A Biol Sci Med Sci. 2006 Oct; 61(10):1090-5.