Associate Professor, Emergency Medicine, Harvard Medical School
Director, Geriatric Emergency Medicine Fellowship, Massachusetts Hospital
Maura Kennedy, MD, MPH
Chief, Division of Geriatrc Emergency Medicine, Massachusetts General Hospital
Emily Hayden, MD, MHPE
Director of Telehealth, Department of Emergency Medicine, Massachusetts General Hospital
Kalpana Shankar, MD, MSE
Health Policy and Research Fellowship Director, Department of Emergency Medicine, Brigham and Women’s Hospital
A Novel Design for an Emergency Department Virtual Observation Fall Prevention Program
About 36 million falls are reported among older adults each year—resulting in more than 34,000 deaths. These falls are costly, and they account for numerous emergency department (ED) visits. Because of crowding, ED staff often miss the opportunity to focus on preventing additional falls. Recognizing the urgency of the problem, and in an attempt to save lives, MGH’s ED recently opened a Virtual Observation Unit (VOU) that provides observation-level care for ED patients in the comfort of their home. This program includes VOU (ED) nurses who assess patients via phone or video, community paramedics who visit patients in their home, and emergency medicine physicians who conduct video visits.
Building on the early success of the MGH VOU program and given the lack of ED fall prevention programs nationwide, Liu’s team proposes to pilot a replicable ED VOU falls program that would: allow ED fall patients who have had an evaluation in the ED to return home if they are deemed safe to do so; perform a home safety evaluation; determine if they require physical therapy; and assess if patients have medications that could increase their risk of falling.
With funding from the Stepping Strong Center, Liu will assess if this program is safe, feasible and acceptable. If the pilot program is successful, she will expand the program to other Mass General Brigham EDs, partner with fall detection device companies, and potentially have certain fall patients evaluated for their falls in their home, avoiding the ED altogether. The overall goal of the program is to decrease the risk of an older person falling again, thus reducing the likelihood of serious injury and death related to falls.
Shan Liu, MD, SD, is an attending physician in the Department of Emergency Medicine at Massachusetts General Hospital. She received her M.D. from Harvard Medical School, her doctorate in science in Health Policy from Harvard School of Public Health and completed her residency at the Harvard Affiliated Emergency Medicine Residency Program. She is currently an associate professor of Emergency Medicine at Harvard Medical School and the MGH Geriatric Emergency Medicine Division Fellowship Director. She is the past president of the Society for Academic Emergency Medicine’s Academy of Geriatric Emergency Medicine and serves on the executive boards of the American College of Emergency Physicians’ Geriatric Emergency Medicine Section and the International Federation of Emergency Medicine Geriatric Emergency Medicine Special Interest Group. She is considered the international expert in the emergency department management of fall patients and leads the Geriatric Emergency Medicine Guidelines group. She has authored publications in US News and World Report, CNN, and the forthcoming book, Masked Hero: How Wu-Lien Teh Invented the Mask That Ended an Epidemic (Publisher Candlewick Press/MIT kids, www.maskedherobook.com).