Introduction: FLASH is new tool developed by the Rehabilitation and Age Care Services Team at the Blacktown Hospital (NSW) which is adapted from OMS and incorporates assessments of high-risk medications and postural hypotension.
Methods: All patients over the course of 4 months, admitted to two (acute geriatrics and neurology) at Westmead Hospital had OMS completed by ward nursing staff, demographic data collected, and a concurrent FLASH done by medical staff part of the research team. Data was analysed using bivariate and multiple regression analyses to determine sensitivities and specificities and to determine if one tool was statistically more accurate at predicting falls in hospital.
Results: Comparisons of the OMS vs FLASH in all age groups revealed similar sensitivities (87.8% vs. 88.5%) and specificities (41.4 vs 37.5%). Due to the low specificity, both falls risk assessment tools were found to have very low positive predictive values (27.8 vs 26.7%). There was no statistical difference between the OMS and FLASH in detecting falls for those aged < 74 and a very small difference (p-value =0.049) for > 75 years. Less than 10% of patients had postural hypotension assessed.
Conclusions: The FLASH is a new falls risk assessment tool that has similar sensitivities and specificities as the OMS. They had similar specificities and therefore negative predictive values. FLASH is comparable to the OMS, but both have limitations. Neither assessment tool had high enough sensitivities and specificities to allow in-hospital falls risk prediction for all age groups and clinical settings.