join the falls prevention virtual learning collaborative

Join the Falls Prevention Virtual Learning Collaborative

Falls Virtual Learning Session # 4 & Closing Congress Team Rapid Fire Presentation Template

MICs Group of Health Services-Anson General Hospital:

Diane Martin, Tammy Brown

Anson General Hospital•One of three partners in the MICs Group of Health Services•Small Hospital in Northern Ontario

• Acute care: 19 beds• Complex Continuing Care: 15 beds

Who We Are

Team Members

Team Member Role

Karen Hill Chief Nursing Officer-Executive sponsor

Isabelle Boucher Director of Quality, Risk and Patient Safety-team lead

Patsy Huber Director of NursingDiane Martin, Cathy Bolton, Tammy Brown

Nursing champions

Joyce Rickard Pharmacy representativeErica Burton DieticianCraig Ogden Physiotherapist

AIM

Purpose of Falls Prevention TeamTo lead and coordinate team learning, process and care improvements; to ensure our targeted goals are achieved in falls and injury reduction and that we contribute as active participants in the SHN Falls Prevention VLC

Scope & Boundaries1.Patients at risk for Falls and Injury from Falls2.Target patients from Acute Care at Anson General Hospital

AIM

Improvement AimReduce incidence of falls (fall rate) by 40% from baseline by March 2011Reduce injury from falls by 40% from baseline by March 2011

Change Ideas

List Changes you have tested during Falls VLC PDSA Cycles:•Adoption of Falls Morse Scale tool on all new admissions•Conduct post falls “huddle” using post falls checklist with all new falls•Ensure high risk patients have documents fall prevention strategies on their care plans•Ensure high risk patients have “apple” logo on spine of chart, at bedside and on white board to communicate risk to other staff•Ensure high risk patients are in a “high-low” bed if available

Baseline Measures

Indicator Baseline measure Target

Fall rate per 1000 patient days 12.44% Reduce by 40%

Percentage of Falls Causing Injury 54.5% Reduce by 40%

Percentage of Patients with completed falls risk assessment on admission 0 100%

Percentage of Patients with completed falls risk assessment following a fall or significant

change in medical status0 100%

Percentage of “At Risk” Patients with a documented falls prevention/injury reduction

plan0 100%

Percentage of residents with restraints in place 90%Maintain atbaseline or

below

Fall Rate per 1000 patient days

% Falls causing harm

55%67%

33%43%

50% 50%

0%10%20%30%40%50%60%70%80%

Baseline October November December January Februarymonths

% of harmful falls

Morse Falls Scale

0%20%40%60%80%100%120%

November December January FebruaryMonths

% Completed Morse Falls Scale on Admission

Completion rate

Goal

Post Fall “Huddles” using Checklist

0%

20%

40%

60%

80%

100%

November December January February

Post Falls Huddles using Checklist

Post Falls Checklist

Post Falls Prevention VLC

Indicator Baseline measure Target February

2010

Fall rate per 1000 patient days 12.44% Reduce by 40% 4.88%

Percentage of Falls Causing Injury 54.5% Reduce by 40% 50%

Percentage of patients with completed falls risk assessment on

admission0 100% 88%

Percentage of patients with completed post falls checklist

following a fall0 100%

Percentage of “At Risk” Patients with a documented falls

prevention/injury reduction plan0 100% 100%

Lessons LearnedList any “key” advice or insights you would like to share with other teams?

Lessons Learned/Key Insights

•Team member roles and responsibilities need to be clear•Team member engagement and commitment is key

•Education for all staff involved is necessary to ensure success•Regular follow-up with progress and data collection

•Measure, measure, measure!

•Reward and recognize team member’s efforts

What are some things you will do to sustain the work on reducing falls and injury from falls and by what date?

Next Steps

Key Sustainability Steps/Plan: Target Dates

Develop standard “falls prevention strategies” for patients at high risk for falls

May 2011

Ensure high risk patients have documents fall prevention strategies on their care plans

May 2011

Continue to conduct post falls “huddle” using post falls checklist with all new falls

ongoing

Name: Isabelle BoucherPatsy Huber

Email: isabelle.boucher@micsgroup.compatsy.huber@micsgroup.com

Phone Number: (705) 273-2424 ext 1156(705) 258-3911 ext 3301

Contact Information