A program spearheaded by two area Kaiser Permanente physicians is receiving attention from the White House.
About a year and a half ago, Dr. David Griffin, a podiatrist at Kaiser’s Mill Plain clinic, and Jeff Gulliford, a physical therapist at Kaiser’s home health services, approached Kaiser’s senior leadership team about identifying and implementing strategies to reduce the rate of falls among seniors.
A work group, led by Griffin and Gulliford, looked for ways to prevent falls across the continuum of care, from the time someone enters the emergency department until they return home or to an outpatient facility. First, they worked internally. Then, they reached out and involved community partners.
“It takes a village to help promote this change,” Griffin said.
The result of those efforts is the SELECT Team — Screen, Educate, Leverage, Evaluate, Champion and Team — program.
The program relies on Kaiser’s integrated delivery system, multidisciplinary teams and community partnerships to support seniors, raise awareness, lower risk factors and tailor interventions to increase confidence and avoid falls.
The strategies aren’t new, Gulliford said. But because Kaiser is a well-integrated system, it allows providers to collaborate, he said.
“We have this foundation that really allows us to do this and, hopefully, do this well,” Gulliford said. “It’s exciting to know we have the potential, and we can help improve and maintain the quality of life.”
Word spread about the Kaiser Permanente Northwest effort and Griffin was invited to do a presentation at the White House Falls Prevention Summit in April. Then, last week, the program was highlighted at the White House Conference on Aging, an event held once a decade to identify ways to improve the quality of life of older Americans. Kaiser Permanente’s national office has also pledged to adopt elements of the program across all of its regions.
“It’s pretty exciting, really,” Griffin said of the national attention. “I’m just a lowly little foot doctor.”
Trying to keep it simple
One in 3 adults 65 and older falls each year, but less than half talk to their health care providers about it, according to the Centers for Disease Control and Prevention.
With that in mind, the first step of the Kaiser program is for providers to simply ask older patients if they’ve fallen in the last year, if they feel unsteady on their feet when walking or standing, and if they are fearful of falling.
“We’re trying to keep it as simple as possible, primarily for the primary care providers, because they’re so busy,” Gulliford said.
If the patient answers “yes” to any of those questions, the primary care provider refers the patient to Kaiser’s fall-prevention class — a free 60- to 90-minute class to educate them about the risks of falling.
At the class, a physical therapist can screen the patient and determine if he or she is at high risk of falling based on gait and balance, Gulliford said. If they are, the patient will then be scheduled for more intensive screening with a therapist, he said.
Primary care providers can also look at other potential risk factors, such as vision issues, cognitive problems and cardiac issues, and refer the patient to the appropriate specialists.
At the hospital level, Kaiser’s Sunnyside Medical Center in Clackamas, Ore., has implemented a “No one walks alone” initiative that calls for all patients to have a staff member at their side when walking.
“That’s a very innovative initiative,” Griffin said.
The program also utilizes outside partners. One partner, the Oregon Health Authority, promotes balance-focused exercise classes, such as Tai Chi for Better Balance, Griffin said. The program is offered at various locations in Oregon and Southwest Washington.
“What we’re trying to do is really promote a higher quality of life,” Gulliford said.
Too often, people believe falling is just a consequence of getting older, he said. That doesn’t have to be the case, Gulliford said. These interventions can help prevent falls and reduce injuries when falls do happen, he said.
“This is something that will change the lives of people for good,” Gulliford said, “or not so good if we don’t do a good job of trying to intervene.”
