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New Hampshire Falls Risk Reduction Task Force (The Task Force)

History of the New Hampshire Falls Risk Reduction Task Force:
In 1999, a New Hampshire injury surveillance report was released, indicating that the rate of falls deaths, hospitalizations, and emergency department visits in the elderly (65 and older) population, unlike other injury causes, had either stayed the same over time or gone up. The New Hampshire Falls Risk Reduction Task Force (Task Force) was organized soon after that to address the report’s concerns. Originally facilitated by the state's Osteoporosis Prevention Program, the leadership soon changed hands to the state's Injury Prevention Program. With an electronic membership of over 300 professionals statewide, the Task Force is made up a variety of disciplines, all working with the elderly, and all sharing a commitment to reducing the risk and numbers of falls among New Hampshire's oldest citizens. Meeting on a monthly basis (approximately 10-20 "regulars" attend), the Task Force has accomplished a lot in its nine- year history. From an early review of the literature and development of "Slips, Trips, and Falls, Prevent Them All", an educational program for seniors to its latest endeavor, advocating routine falls screening in primary care practices, the work of the Task Force has covered the gamut of falls risk reduction work. The Task Force joined the National Falls Free® Coalition early in the Coalition's existence and has supported many of the recommendations in "Falls Free: Promoting a National Falls Prevention Action Plan, National Action Plan" (National Council on Aging, et al; 2005). Highlighted in the document "Making A Difference" (The Association of State and Territorial Health Officials and the State and Territorial Injury Prevention Directors' Association, 2006) and “The State of Aging and Health in America, 2007” (Centers for Disease Control and Prevention and the Merck Company, 2007), the Task Force's work has been recognized locally, statewide, nationally, and internationally. The Task Force presented at the joint Centers for Disease Control and Prevention/State and Territorial Injury Prevention Directors’ Association Oklahoma City conference in April of 2008.

Organizations that took the lead in developing the New Hampshire Falls Risk
Reduction Task Force:
Three key organizations are key to the ongoing success of the Task Force: the Department of Health and Human Services' Injury Prevention Program (Co- Chair of the Task Force); the Injury Prevention Program at Dartmouth (Co-Chair of the Task Force); and the Department of Health and Human Services' Osteoporosis Prevention Program

Goals and objectives of New Hampshire Falls Risk Reduction Task Force:
The goals of the Task Force were established to include:     

  • Reduce the rate of death and disability in the elderly due to falls.
  • Reduce the risk of falling in the elderly population.
  • Educate and train professionals working with the elderly.

Funding sources for the New Hampshire Falls Risk Reduction Task Force:
The Task Force has no direct funding sources. Members’ sponsoring organizations donate their time and other in-kind contributions. Members seek out grants for specific activities and interventions (based on data, need, etc.). The Task Force and its member partners have received funding from the following sources including, but not limited to:

  1. Centers for Disease Control and Prevention
  2. Endowment for Health (NH based organization)
  3. New Hampshire Charitable Foundation
  4. New Hampshire Council on the Arts
  5. National Safety Council
  6. Consumer Product Safety Commission

Organizations that are playing a key role in the New Hampshire Falls Risk
Reduction Task Force:
Many organizations are active in the Task Force with several playing key roles, including: the Department of Health and Human Services' Injury Prevention Program
Injury Prevention Center at Dartmouth; the Department of Health and Human Services' Bureau of Elderly and Adult Services; as well as many of the state's hospitals and long term care facilities, which give their staff the time to attend Task Force meetings and to facilitate projects.

Structure and function of the steering committee:
The Task Force meets on the first Tuesday morning of every month in Concord at the Department of Health and Human Services.

2-3 challenges encountered:
The Task Force is always seeking funding for its activities, which takes up quite a bit of staff time. Although the Task Force's membership has stabilized, finding new (and active) members is an ongoing activity. Active participation in the Task Force involves a commitment of time, which can be difficult for its members, many of whom are practicing clinicians.

2-3 recent successes to share:

  • Integration of falls screening in thirteen community health centers, funded through the state’s primary care system.
  • Completion of a yearlong evaluation of coalition infrastructure and functioning; now beginning to implement some recommended changes.
  • Finished draft final report of the 2005-2006: Best Practice, Falls Risk Reduction Project with 20 teams across the state. These teams were initially trained in March of 2005 and completed a yearlong project in June of 2006 -- with mentoring from the Task Force Teams -- on facilitating a falls risk reduction project in their r respective settings. Teams broadly represented community based, long term care, and acute care settings.

Outcomes being monitored:
The Task Force evaluates all of its projects, which includes process and outcome measures. Evaluation strategies can include number of falls, scores on the Timed Up and Go, or other measures. Some of the more global measures include, but are not limited to:

  • Deaths, hospitalizations, and emergency department visits due to falls.
  • 911 calls due to falls.
  • EMS runs due to falls.

The Dartmouth-Hitchcock Medical Center’s Injury Prevention Center currently hosts information on preventing older adult falls at http://chad.dartmouth-hitchcock.org/injury_prevention/injury_center_programs_falls.html. The information includes a comparison of assistive devices (advantages and disadvantages of each) and information about the problem in New Hampshire and the development of the New Hampshire Falls Risk Reduction Task Force.

For additional information, visit the New Hampshire Falls Risk Reduction Task Force website at www.nhfallstaskforce.org or contact:

Rhonda Siegel
Injury Prevention Program
New Hampshire Dept of Health & Human Services
29 Hazen Drive
Concord, NH 03301
Phone: (603) 271-4700  
RSiegel@dhhs.state.nh.us

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