Abstract
Whilst providing an Emergency Department based Older Person Assessment and Liaison service (OPALs), patients were identified to attend following a fall when they had previously been seen in ED following falls during the preceding 3 months. When notes were reviewed, few fall referrals had been documented.
A prospective audit was conducted to identify the number of eligible patient referrals to falls team for patients who attend the emergency department. Electronic patient records were screened to identify patients' discharge diagnosis of ‘fall’ ‘elderly fall’ or ‘head injury’ (included if the cause was a fall).
41 patients were discharged from the emergency department following a fall, 2 patients attended and were discharged twice in this time creating a total 43 attendances. 13 attendances were in hours 8-5pm, and 30 out of hours. The average patient age was 81.72 years (range 65-95 years).
13 patients had a falls history documented using phrases such as ‘frequent falls but no major injury’ and ‘h/o multiple falls’ and ‘2 in 12 months (6/12 ago)’.
1 patient had a documented falls referral completed by Occupational Therapist. No other falls referrals were documented.
This work has identified a gap in onward referral of patients who have fallen. Many of the assessments recommended by NICE could begin within the emergency department. This work recommends the design of a falls assessment and referral flow chart for use by staff in the department to demonstrate the assessments that should be undertaken and direct staff to complete appropriate referrals.