A health plan in California is providing fall prevention training to medical office staff. Nonclinical staff often are overlooked in fall prevention efforts.

  • Staff are taught why senior patients are reluctant to discuss falls.
  • The program includes simple tests for assessing fall risk.
  • A tool kit helps office staff conduct fall risk assessments in the office.

Fall prevention efforts focus almost exclusively on clinicians such as nurses and therapists. Sometimes, it includes other healthcare employees who encounter patients regularly, such as those in housekeeping or dietary services. But clerical office staff typically are not included.

They are included in a program offered by SCAN Health Plan, based in Long Beach, CA. SCAN offers several Office Staff Training (OST) courses to medical groups. One of the most popular is a fall prevention course called Stand Up 2 Falls — Maximizing Mobility.

Over the past 18 months, more than 230 front and back office staff, representing seven provider groups, have participated in the fall prevention course. The program covers fall risk factors, best practices, and various assessments, giving staff the tools to identify their patients at risk for falls and create individualized action plans, including education and mobility interventions.

SCAN is a Medicare Advantage plan serving only senior patients, so fall prevention is a top priority, says Eve Gelb, senior vice president of healthcare services with the health plan. The fall prevention efforts target senior patients in community settings, rather than inpatient facilities, she explains.

“Our office staff training is about working with our provider partners, the physicians, and their staff in the ambulatory setting to help them understand the fall risk for seniors, and how to prevent falls when they’re out and about in the community,” Gelb says.

The physician only spends a few minutes with each patient, but office staff often spend much more time with them, Gelb says. That means they could prevent falls if they are properly trained.

“They’re the ones who watch the patient walk in from the street. They observe the patient getting up from a chair in the waiting room and walking to the exam room,” she says. “These folks are in a great and unique position to identify people who are at risk from falling, because a lot of that identification comes from observing gait, how quickly someone can get up from a sitting position, how steady they are on their feet.”

Physician practices can train their entire staff, or they can send designated employees for a train-the-trainer program, Gelb explains.

“It’s about educating staff to understand the importance of preventing falls among seniors, to create that desire to do something about it. We teach them how to perform specific fall screening to identify seniors who are at risk of falls or have balance issues,” she says. “We teach them how to coach patients about falls risk and mobility, because a lot of seniors don’t think falling is a big deal and they don’t want to draw attention to it. They think that if they tell someone they’re falling, people will think they can’t take care of themselves, and put them in a nursing home.” The program is extremely well received by both the office staff and physicians, Gelb says.

The program teaches office staff to bring up the subject of falls with seniors because the patients are unlikely to bring it up themselves, Gelb says. Office staff receive suggested questions to ask seniors, along with simple tests that can be performed with patients to assess fall risk.

“We also give them tool kits for their offices that include things like a 10-foot tape measure they can use to mark the distance in the hallway, and time how long it takes a patient to walk that distance,” Gelb says. “We teach them how to do the assessments and give them some of the tools they will need.”


  • Eve Gelb, Senior Vice President of Healthcare Services, SCAN Health Plan, Long Beach, CA. Phone: (800) 559-3500.