Creating a Fall Prevention Program in Your Podiatry Practice

Falls are the leading cause of injury among adults age 65 and older. More than 14 million older adults (approximately one in four) report falling each year. Although falls are common, they are not an inevitable part of aging.

Podiatrists are uniquely positioned to recognize fall risk before a serious injury occurs and help patients take steps to prevent falling. Many risk factors can be identified and addressed before a fall results in injury, hospitalization, or loss of independence. Implementing fall prevention in your practice improves patient outcomes while creating a meaningful new revenue opportunity for your practice.

A successful fall prevention program does not have to begin as a complicated new clinical service. It can start by training every member of the practice to recognize opportunities, establishing a simple screening and referral process, and providing patients with credible resources they can use to begin reducing their risk.

Patients often reveal important warning signs during podiatric visits. They may struggle to rise from the treatment chair, hold onto the wall while walking, arrive in unstable footwear, report numbness in their feet, or mention that they have recently become less active. Though these may not be the primary reason for the appointment, these observations provide an important opportunity to begin a fall-prevention conversation.

Fall Prevention Program Resources

Make Fall Prevention a Team Responsibility

One of the most important steps to creating a fall prevention program is helping staff understand fall signs and train them to start the conversation. Every patient interaction offers a different opportunity to notice a potential concern.

Frame fall prevention as a way to protect mobility, confidence, and independence. This is often more motivating than focusing exclusively on injury. Staff should avoid language that feels alarming, judgmental, or dismissive. Instead of saying: “You look like you are at high risk of falling.” Try: “We noticed that walking seemed a little more difficult today. Have you felt unsteady recently?”

The whole staff can work together as a team. Front-desk employees may see a patient having difficulty entering the office or navigating a step. Medical assistants may notice that a patient needs the wall, furniture, or another person for support. Providers may identify foot pain, weakness, sensory loss, deformity, or unstable footwear that could affect gait and balance.

The goal is not to ask staff members to diagnose fall risk. Instead, train them to recognize observations that should be communicated to the clinical team. Staff should be encouraged to look for signs such as:

• Difficulty standing up or sitting down

• Unsteadiness when walking or turning

• Holding onto walls, counters, or furniture

• Use of a cane or walker while shuffling or dragging feet

• Foot pain that changes the patient’s gait

• A recent fall, near-fall, or fear of falling

A brief staff training session can include examples of these warning signs, instructions for documenting concerns, and a clear process for notifying the provider. Reinforce the idea that staff members are not labeling a patient as a “fall risk.” They are simply identifying an opportunity for further evaluation.

Build Screening Into the Existing Workflow

Fall prevention is more likely to become routine when it is incorporated into existing systems rather than treated as an occasional special project. A practice might begin by screening patients age 65 and older annually, while also screening any younger patient who demonstrates significant balance, neurological, musculoskeletal, or mobility concerns.

Front desk staff can screen for fall risk with three straightforward questions:

1. Have you fallen in the past year?

2. Do you feel unsteady when standing or walking?

3. Do you worry about falling?

A “yes” response to any of these questions should prompt additional discussion and, when appropriate, further assessment or referral.

Practices can also incorporate these questions into intake forms, annual history updates, electronic medical record templates, or rooming procedures. The process should be brief enough that it is consistently completed.

Identify the Risk Factors Podiatrists Can Influence

A complete fall-risk evaluation may involve medication review, vision assessment, cardiovascular concerns, cognition, home safety, strength, balance, and other factors. Podiatrists are not expected to manage every element independently. However, they can make meaningful contributions within their area of expertise.

During the foot and lower-extremity examination, consider factors such as:

• Pain that causes limping or compensatory gait

• Peripheral neuropathy and sensory loss

• Muscle weakness

• Limited ankle or first metatarsophalangeal joint motion

• Foot deformities that reduce stability

• Calluses, ulcers, or lesions that alter weight-bearing

• Leg-length differences

• Ankle instability

• Difficulty clearing the foot during swing phase

• Poor footwear selection

• Worn or inappropriate orthotic devices

• Difficulty safely using prescribed braces or assistive devices

When appropriate, podiatric intervention may include treating painful conditions, addressing pressure areas, improving footwear, and helping patients achieve a safer and more consistent gait. Routine foot care and properly fitted, supportive footwear can help reduce fall risk while also creating a valuable and profitable service opportunity for the practice.

Podiatrists can encourage secure shoes with good support, nonslip soles, low heels, and appropriate fit. Further aids such as custom AFO braces and orthotics will also help. These interventions should be coordinated with the patient’s larger fall-prevention plan.

Every Visit is an Opportunity for Prevention

Implementing a fall prevention program does not need to be complicated! Start with a simple approach by training staff to recognize warning signs and using a standardized

assessment tool. This process will allow you to identify patients at risk, uncover gaps in their current treatment, and provide appropriate fall prevention recommendations.

The goal is not for your podiatry office to manage every part of fall prevention, but to make it a natural part of patient care. A few simple steps taken during their visit can help protect mobility, preserve independence, and potentially prevent life-changing falls! Failing to address these needs may mean overlooking valuable treatment opportunities and leaving meaningful revenue on the table. Contact us if you need any help, need fall prevention resources, or have questions.