The Oregon Senior Falls Prevention Program

Transcription

1 The Oregon Senior Falls Prevention Program Lisa Shields Senior Falls Prevention Program Injury and Violence Prevention Program May 28, 2014

2 Topics covered Oregon Snapshot Program Overview STEADI and community programs Collaborating with Health Systems 2

3 Oregon Health Authority OHA includes most of the state's health care programs including Public Health OHA Center for Prevention and Health Promotion Injury and Violence Prevention Section Senior Falls Prevention Program Adolescent, Genetic, and Reproductive Health Section Environmental Public Health Section Health Promotion and Chronic Disease Prevention Maternal and Child Health Section Women, Infants, and Children (WIC) Program 3

4 State-specific healthy life expectancy in years at age 65 years, Source: Centers for Disease Control and Prevention

5 Falls in Oregon Each year nearly 600 Oregonians die and 8,500 are hospitalized due to a fall The rate of death due to falls has increased nearly twofold (92.3%) since 2000 The rate of fatal falls for those 85+ is 26x greater than those age Nearly 60% of seniors in Oregon who are hospitalized for falls are discharged into long-term care Injury in Oregon Annual Data Report 2012 Falls Among Older Adults in Oregon 2012 Oregon Injury Prevention Plan

6 The cost of falls Fall hospitalization cost for Oregon seniors is $121.6 million per year Unintentional falls were the third most costly hospitalized condition after cancer and heart disease The median per patient hospitalization costs for fallrelated injury is $30,467 Injury in Oregon Annual Data Report

7 Oregon senior falls prevention Health systems Health plans Community programs Clinician education and referrals (STEADI) Community health workers, volunteers, professional organizations, aging services First responders Public awareness 7

8 Incentives and Motivators for Health Care and Falls Prevention MEDICARE Welcome to Medicare visit Annual Wellness Visit 5-star health plan rating Physician Quality Reporting System (PQRS) Patient-centered Primary Care Homes 480 recognized Oregon clinics Coordinated Care Organizations (CCO) Serving 90% of Oregon Health Plan (Medicaid) members Comprehensive Primary Care initiative Oregon is one of 7 national markets 67 clinics ABIM and ABFM maintenance of certification credits 8

9 Public Health - Health System collaboration Falls prevention champions in health care Geriatrics, Primary Care, Quality Improvement, Physical Therapy & Rehabilitation, Inpatient falls prevention, ED/Trauma Key to sustainability: work together to tailor programs that align with each business model 9

10 Oregon Coordinated Care Model Best practices to manage and coordinate care TRIPLE AIM: better health, better care, lower costs Transparency and clear information Shared responsibility for health Payment for outcomes and health Performance is measured 10

11 STEADI pilot OHSU Internal Medicine and Family Medicine clinics OGEC: STEADI to rural clinics CDC has funded OHSU to implement and evaluate STEADI in electronic health record Working with national EHR vendor to disseminate nationally 11

12 Community programs Tai Chi: Moving for Better Balance Developed at Oregon Research Institute Over 350 TCMBB instructors trained Fitness centers, health care settings, parks and recreation facilities, senior centers, assisted and independent living Stepping On Instructors trained from Providence, Legacy, Kaiser, the VA, senior living, fitness centers Otago Exercise Program STEADI referrals to Otago clinic OPTA publicizing Otago program to PTs 12

13 13 Health system partners

14 Class pyramid for STEADI referrals Physical Therapy (e.g., Otago, Neuro) -Needs one-on-one therapy -Moderate to severe balance problems -May be homebound, cognitively impaired Stepping On / A Matter of Balance -Cognitively Intact -Mild to moderate balance problems Tai Chi programs - Cognitively Intact -Few balance problems Traditional and older adult exercise programs such as standing strength and balance classes, dance, bowling, golf, ping pong, badminton - Cognitively Intact -Few balance problems Copyright 2005, Mahoney J, Shea T, with Dane County Falls Prevention Task Force

15 15 Google class listings map

16 16 YouTube Channel for instructors

17 17 Healthoregon.org/fallprevention

18 Health plan coverage Tai Chi and Stepping On Medicare Beneficiary Fitness Programs Silver and Fit Silver Sneakers SamHealth Tai Chi: Moving for Better Balance (TCMBB) is approved programming OHA trained 60 Silver and Fit fitness instructors Providence Health Plan Stepping On fully subsidized by 2016 Portland VA Medical Center Co-pay waived Travel reimbursement for 60 miles or more 18

19 19 Community Health Workers and volunteers

20 20 Aging services and professional organizations

21 Public Awareness Healthoregon.org/fallprevention Program info, class listings, instructor resources, data, news State Aging and Disability Resource Connection website Falls program listing searchable by county Falls Prevention Awareness Day Tai chi flash mob Press release Public Health Twitter and FaceBook Governor s and county proclamations Presentations and screenings at senior centers and churches 21

22 Hospital Discharge Data shows Promising Trend Fall hospitalization rates per 100,000 in three older adult age groups in years, Source: Oregon Hospital Discharge Index

23 Tai Chi flash mob Senior center exercise demo Tai Chi with County Commissioners 23

24 Oregon Testimonials Before attending these classes my balance was so poor that I was afraid I would fall in the shower Tai chi and the exercise classes really do work! I now don't use a cane and am not afraid of falling the doctor was very pleased with my walking because both arms swung like they should, and I did not walk with a shuffle as do so many Parkinson s patients, but rather with a normal gait and bounce. I wouldn't miss a Tai Chi class for anything.

25 Contact Information Lisa Shields 25