Study: Falling like 'parachutist' lowers seniors' hip fracture odds by 70%

If falling seniors tumble like a landing skydiver-and do it promptly-they can reduce their likelihood of a hip fracture by 70%, University of Michigan researchers say.

Computer simulations showed that crouching and then leaning during a fall so the outside of the lower leg hits before landing on one's backside will dissipate the force on the hip to only 25% of what is needed to break it. Investigators say their research into the value of sideways falling methods is unique.

"In this study, we asked whether it matters what you do in the air after you start to fall," said James Ashton-Miller, a professor in the departments of Biomedical Engineering and Mechanical Engineering. "We found that a parachutist's landing style reduces your risk of injury, and you can land a fall safely with or without your hands."

Delaying the use of the parachutist strategy by more than two-tenths of a second increased the impact of the fall by 70%, he added.

MANAGE CHANGE BEFORE IT MANAGES YOU.
 
Like the weather there are changes we as individuals or organizations cannot control. Also, like dealing with the weather, we can at least come in out of the rain.  There are many things that we can choose to do something about, choose to participate in and help our organization to succeed under new circumstances.
 
It is more important than ever that practical plans be made in advance for developments that not long ago were unthinkable.  Fast, accurate, two-way communication now becomes vital in healthcare's life saving role.  And that communication must cover other organizations, local, state and federal, health, safety and law enforcement agencies that may not have been in the picture before.  All this must happen while technology is improved and new people with new and different backgrounds are being brought into health oversight agencies. All of this must happen such that priorities as well as funds are integrated, so that important functions of the past are carried out along with newly developing needs.
 
With this level of disruption, even though much of it is positive, careful planning for and implementing of change efforts must occur if our healthcare organizations are to be successful.  Although efforts are being made to plan for the technical changes in lab equipment, clinical policies and software, oftentimes there is no corresponding effort being put into the human side of change.  Without this effort, the real change you want may not occur and implementation could fail.  Perhaps, unlike the past, we may not get a second opportunity to do the job right.
 
Change is a disruption in expectations
 
What is change?  Change is a disruption in expectations.  It's a dramatic departure from what was expected.  Even change that is viewed as overwhelmingly positive can be generally disruptive and therefore will generate resistance.  When people resist change they are resisting the loss of control caused by their expectations being disrupted.  This resistance is always expensive.  You pay the price to plan and minimize it, you pay the price to heal from it or you pay the price of failure.  But always, you pay!
 
Often, during a period of change, there will be high but undirected energy that creates conflicts and increases in error rates.  Again, change exacts a price but it is a price we can work to lower.  People go through a predictable response to change; in fact it's much like the steps we go through as we react to the largest change process possible - death and dying.  Because we know to watch for things like immobilization, denial, anger and testing, we can plan for change and help people through it at their own pace based on their individual life experiences.
 
Senior leaders often underestimate and under measure the basic requirements necessary to really change an organization.  They under plan, under budget and under sell the new idea within their organization, virtually assuring long run failure. At a recent meeting in an impressive, large, multi-hospital system, a discussion was held on the need for improvements in productivity.  Over 15 years ago this system set out to follow quality guru Dr. Deming to improve quality and productivity and to lower costs.  Today they are rehashing old issues and fighting old battles.  The saddest part is that they don't even recognize that they are taking a circular path over old ground because so few of the key players from 15 years back are still employed anywhere in the system.  The changes that were planned were never systematically implemented.  They failed to take hold and they died.  In effect, management never provided the leadership required to institutionalize the changes they felt were necessary.  They thought that by giving the topic attention for a year it would become ingrained in the organization.  They thought it would thrive on its own when new pressures changed management's focus.
 
So, where can an organization start in the journey to improve its track record in implementing change?  First, take a look back.  Conduct a detailed assessment of several past changes, both successful and unsuccessful if possible, so that we have a realistic starting point for our new effort.  Examine issues like:
 
Did the change come off on schedule? 

Was a budget established for the change?

What did it cost compared to its budget? 

Did the governing board have a role in the change?

What are the documented results?

Did management see the change as successful?

Did employees see the change as successful?

Did physicians see the change as successful?

Did customers (clients, patients, etc.) see the change as successful?

Did the community see the change as successful?

What did we learn from the implementation?

After the assessment results are in, use them as the starting point for detailed planning for the new strategic change.  This plan should include ongoing two-way communication using as many forums as possible.  The board and senior leadership must understand and support the plans.  Every department should be consulted as to their view of the effect of the change on their areas.  Written policies and procedures must be altered to reflect the new direction.  Human resources should discuss the new policies in interviews with prospective employees and orientation programs should also reflect these policies.  Most importantly, measures must be established, implemented and monitored over time to assure that the change had the desired effect initially and is still having the desired effect over time.
 
Sometimes we initiate change, often we react to change.  We must do a better job of managing and incorporating change and statutory requirements such that positive improvements are not only made but become part of day-to-day life inside the organization.  It's too important to leave to chance.


Ken Bast