The national reducing harm from falls programme was led by the Health Quality & Safety Commission, working in partnership with a wide range of stakeholder organisations, and ran from 2012 to 2018.
The programme achieved its aims by working from an evidence base to reduce the risk of falling, rate of falls and severity of injury, and promote the best possible outcomes for those who have suffered harm related to a fall.
The Commission's quality and safety markers were designed to evaluate the success of the programme interventions; they measured care processes and outcomes. From 2021 the process markers no longer needed to be sent to the Commission because the programme entered the sustainability phase. Ongoing monitoring now occurs through the outcome measure.
As the programme was preparing to finish, the results to end September 2017 showed that there had been 107 fewer fractured neck of femurs as a result of an inhospital fall across New Zealand than would otherwise have been expected. This equalled a saving of direct costs of NZ$5 million. On average an avoided broken hip gives an extra 1.6 years of healthy life, this added up to an additional 175 years of healthy life, worth NZ$31.7 million. These results demonstrated the achievement of the programme and a basis for the move to sustainability in 2018.
The programme’s success was made possible by the engagement of stakeholder organisations that worked in partnership with the Health Quality & Safety Commission.
The challenge remains to identify people vulnerable to falls, or specific groups of people such as those with cognitive impairment, within the community and inhospital settings and to maintain initiatives to enable safe and healthy lives.
Useful links and resources
- The reducing harm from falls recommended evidence-based resources 2020 includes systematic reviews, clinical guidelines and toolkits.
- A webinar supporting the 2020 evidence-based resources.
- Recent literature of interest from the Reducing harm from falls: recommended evidence-based resources 2020.
- The final updated 10 Topics in reducing harm from falls (2020).
- The 2018/19 evidence base.
- Care Companion Programme workbook (Bay of Plenty DHB) to accompany the 2019 falls evidence base (reproduced with permission).
Guidance on the prescribing of vitamin D
It is important to maintain adequate vitamin D levels all year round for bone health (Ministry of Health and Cancer Society of New Zealand 2012). Low levels have been associated with reduced bone mineral density, high bone turnover and increased risk of hip fracture (Nowson et al 2012). There is an association between lower serum vitamin D levels and falling (Annweiler and Beauchet 2015).
- Vitamin D and calcium supplementation in primary care: an update (bpacnz)
- Guidance on the diagnosis and management of osteoporosis in New Zealand (Osteoporosis New Zealand)
- To understand how vitamin D fits into an individualised falls risk assessment and multifactorial care plan for an older person, see the reducing harm from falls Topic 3 and Topic 4.
- Annweiler C, Beauchet O. 2015. Questioning vitamin D status of elderly fallers and nonfallers: a meta-analysis to address a 'forgotten step'. Journal of Internal Medicine 277(1): 16–44.
- Nowson CA, McGrath JJ, Ebeling PR, et al. 2012. Vitamin D and health in adults in Australia and New Zealand: a position statement. Medical Journal of Australia 196(11): 686–7.
Ask assess act resources
In 2018 the Commission worked with the Accident Compensation Corporation to update the Ask assess act resources and include them as part of the Live Stronger for Longer movement. The updated resources are:
- Live Stronger for Longer Ask assess act pocket card
- Live Stronger for Longer Ask assess act information poster
- Live Stronger for Longer Ask assess act consumer poster
- Live Stronger for Longer Ask assess act clinical staff poster
These can be ordered for free via ACC’s website.
To find out more about Live Stronger for Longer visit their website.