Lift the Health of Aucklanders Improve Performance Live Within Our Means

Healthy CommunitiesQuality Healthcare

Reducing the Incidence of Falls and Pressure

Injuries for Older People

Jane LeesADHB

Healthy Communities, Quality Healthcare 2

Falls and PI Projects at ADHB

September 2011:

ADHB Establishes Falls & PI Projects

– Project Manager for each, both Part Time

– Combined Falls & PI Steering Group

Meet Fortnightly

– Main Focus on Provider

ARRC Sector mentioned but little focus

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Falls and PI Sub Group

Late 2011:

Created a Project “Sub Group” for ARRC Sector

– Representatives from six ARRC facilities

– Representation on Provider Steering Group

– Meet every six weeks

– Purpose of group

Establish Baseline Data

Establish Consistent Collection Methodology

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ARRC Sector Costs to ADHB

March 2012:

Identified cost of sector related falls within Provider

– Primary Diagnosis was a Fall

– Originator from a ARRC Facility

Summary of Findings– 539 falls, 469 residents (12% of total ADHB)

70 repeat fallers within the year (15%)– $6.8 million for direct treatment, average $13k– 7325 bed days, average 14 bed days

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ARRC Sector Wide Engagement

Held whole of Sector meeting on Falls & PI

– 60+ attendees, 40+ facilities

Message: Open and Honest

– regarding hospital issues collecting data

– regarding numbers and costs

– by providing our tools and templates

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continued…

Discussed Falls and PI to determine

– if they collect and how:

Yes, although various ways

– Do they categorise

Yes, but various different methods

– are they willing to share:

Yes

Discussed the best way to engage going forward…

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Cluster Model Approach

Concept

– Group the facilities into geographically based groups

Purpose:

– Discussions on data collection and categorisation methods

– Sharing of improvement ideas and strategies

– Provide “safe” environment

– Aggregate and disseminate information

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Cluster Hosts

Asked for Volunteers from the Facilities to Host

Cluster Host Responsibilities

– Provide a facility for people to meeting

– Provide refreshments

– Facilitate the meetings (but this can be rotated)

Good response with Hosts covering most of the Region

– Build the clusters

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Cluster Regions

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ADHB Cluster Support

ADHB will provide support to Cluster Hosts by

Providing Project Documents

– Terms of Reference

– Background Information

– Agendas

– Minutes Templates

Representative on each cluster

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First Cluster Host Meeting

First Cluster Host Meeting Held:

– Agreed happy with cluster groups

– Discussed Background Documentation

– Discussed agenda for first meeting

– Meets ADHB support people

– How to collect data (email, Excel, website etc.)

Message: what’s easiest for them – be flexible

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Collaboration Model

ADHB

Cluster Hosts (13)

ARRC Facilities (68)

Cluster Host Meeting

Cluster Meeting

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Meetings

Cluster Host Meeting

Provide feedback from / about Cluster Meetings

Review data compliance

Set Agenda / theme for next meeting

Cluster Meeting

Discus previous results

Issues / problems

Work through Agenda

Share solutions / ideas

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Advantages of this Approach

Jointly driven by ADHB and ARRC Facilities

Collaborative working relationship

Consistency of approach / methodology

Develop approaches / solutions that work for everyone

Enable collaboration between facilities

Opportunity to introduce other topics in the future

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Lessons Learnt

There is not a consistent method of collecting or categorising data

– Manual vs electronic, separate vs clinical records

We don’t have the information to identify where PIs are occurring

– Don’t know where to focus improvement effort

Need to collect data by facility type

– Dementia, Private Hospital, Rest Home etc

20% of ARRC Hospitalisations involve fracture of the Hip or Femur

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Questions?