Falls
Emergency department referrals
All urgent cases must be discussed with the on call Registrar to obtain appropriate prioritisation and treatment. Contact through:
- Caboolture Hospital (07) 5433 8888
- Redcliffe Hospital (07) 3883 7777
- Royal Brisbane and Women's Hospital (07) 3646 8111
- The Prince Charles Hospital (07) 3139 4000
Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.
If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region:
- Any fall occasioning serious trauma (including fractures, major soft tissue injury, head strike or concussion) that cannot be managed in primary care
- Frequent falls (more than one every few days)
Does your patient wish to be referred?
Minimum referral criteria
Does your patient meet the minimum referral criteria?
Category 1
Appointment within 30 days is desirable
- Two or more falls in the previous month
Category 2
Appointment within 90 days is desirable
- Two or more falls in previous 12 months
- Falls as part of an overall decline in physical, social or psychological function
Category 3
Appointment within 365 days is desirable
- No category 3 criteria
If your patient does not meet the minimum referral criteria
Consider other treatment pathways or an alternative diagnosis.
If you still need to refer your patient:
- Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
- Please note that your referral may not be accepted or may be redirected to another service
Other important information for referring practitioners
Not an exhaustive list
- Refer to HealthPathways or local guidelines
- A history of falls in the past year is the single most important risk factor for falls and is a predictor for further falls.
- Older people reporting a fall or considered at risk of falling should be observed for balance and gait deficits. They should be considered for interventions that improve strength and balance.
- Consider referral to clinical pharmacist for Home Medicines Review if evidence of polypharmacy.
- Consider referral to specialist falls clinic (if available) if patient has suffered multiple falls with no cause found.
- Depending on specialist availability, patients with falls can be referred to either general medicine or geriatric medicine. In the setting of multiple geriatric syndromes, referral to geriatric medicine may be preferred.
- The following links to cognitive assessment tools may be useful:
- Evidence for fall prevention strategies:
- exercise
- high dose vitamin D
- medication withdrawal (particularly antidepressants, antipsychotics and benzodiazepines)
- occupational therapy home visit
- restricted multifocal spectacle use
- expedited cataract surgery (where required)
- podiatry assessment and intervention
- multifactorial assessment with targeted interventions (including referral to physiotherapist, occupational therapist and/or dietitian as appropriate)
Referral requirements
A referral may be rejected without the following information.
- Relevant medical history, comorbidities and medications (including an assessment of adherence)
- Number of falls in the previous 12 months
- Assessment of cognitive function (MMSE, MOCA or other validated tool) in patients ≥ 65 years of age
- Chronological profile of the impact of symptoms on ability to function
- Bone mineral densitometry report, Vitamin D assay (if performed)
- FBC & ELFTs
- MSU M/C/S
- Results of any therapeutic drug monitoring performed within three months of referral
Additional Referral Information (Useful for processing the referral)
- Existing psychosocial issues and supports (family, carers, home services, etc)
- Copies of discharge summaries and outpatient letters relating to hospitalisations for falls, or visits to fall clinics, or home assessments for falls risk, if available
- Home Medicines Review report if available
- Nutritional status
Out of catchment
Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can’t order, or the patient can’t afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
Send referral
Hotline: 1300 364 938
Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs
Mail:
Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
Access to Health Pathways is free for clinicians in Metro North Brisbane.
For login details email:
healthpathways@brisbanenorthphn.org.au
Login to Brisbane North Health Pathways:
brisbanenorth.healthpathwayscommunity.org