Because falls are the leading cause of injuries to older people, the Reducing Harm from Falls programme developed the Ask, assess, act initiative as part of the national patient safety campaign Open for better care.
Clinical guidelines recommend routine screening for falls risk for all older people, based on evidence in cohort studies that an older person who has had a fall is at risk of a subsequent fall, and that mobility impairment, gait disorders and balance deficits are significant risk factors[1, 2, 3].
Screening means that falls risk assessment and appropriate interventions can be targeted to those most likely to benefit ie, those most at risk.
Since older people can have several risk factors needing intervention, and each older person will have a different risk profile, it is not surprising that systematic reviews have found that multifactorial assessment and interventions reduce the rate of falls in community-dwellers and hospital inpatients, and may reduce falls in older people in residential care[5, 6].
In practice, multifactorial risk assessment and intervention involves ‘… systematically checking for and acting on falls-related risks factors that could be treated, modified or better managed in individual patients’, and includes the management of underlying conditions.
ASK the older person three simple screening questions.
ASSESS the older person to identify their particular falls risk factors.
ACT by putting in place individualised interventions and supports to address their risks.
The Ask, assess, act resources are outlined in the helpsheet and are available from the Commission’s website for you to download and print. Free printed copies of the promotional posters and pocket cards can be requested by emailing email@example.com.
The Ask, assess, act resources are based on:
A number of district health boards and other providers trialled the Ask, assess, act initiative in 2013 - here’s a story from an outpatient department at Waikato DHB.
The resources have been updated for use in April Falls 2014 activities, with an overview of care after a fall being added to the pocket card. The resources promote the Ask, assess, act process and can be used to support existing assessment and care planning tools, or to highlight what might be included or changed.
The Ask, assess, act process is ideally used in hospital, primary health care, and community (home care) settings, but the principles also apply in age-related residential care.
We welcome feedback on the format, content and usefulness of these resources – please get in touch with us at firstname.lastname@example.org.