Documented, Systematic and Individualized Communication With the Attending Physician for Fall Risk Reduction/Injury Mitigation Care Planning.

Falls are common in nursing homes (NHs) and may result in serious injury to the resident as well as legal and regulatory liability for the NH. Some of these falls and injuries might be avoided if attending physicians were involved in risk reduction. I developed a communication tool to solicit from attending physicians specific risks for patients most likely to experience a fall and injury, and to consider strategies to reduce those risks. The communication tool addresses medications, osteopenia, vitamin D deficiency, vision, hearing, gait/balance/peripheral sensation, injury mitigation, altered mental status, restraints, and philosophy of treatment. An important component of implementation is to ensure full participation by the attending physician. Suggestions for implementation and evaluation are discussed, as well as potential application to clinical problems other than falls.