Community Falls Prevention in Canterbury Keeping Les & Gloria upright at home Ken Stewart Canterbury DHB Falls Prevention Clinical Lead HQSC Falls Expert Advisory Group May 2013 Intro Community based funding and delivery model setup and RFP pending put together a performance improvement model that delivers on our CCN targets and is within budget we looked at historical, current and potential issues strategically rather than scripting contracts for clinicians as this approach needs to evolve based upon issues as they arise in next 12 months particularly This also needs to be an effective engagement strategy for all clinicians across the system We have designed a funding and delivery model to provide a sustainable OEP type programme and a SOYF programme for Cantabrians

Where were we 2 years ago? CDHB Clinical Board recognised falls were a problem in our hospitals Recognised impact of falls upon frail elderly in all settings Hospitals –stories from RCA’s + whole system Aged Residential Care Community We gathered data for falls in all of these areas We reviewed the evidence for reducing harm from falls to match our aim of Zero Harm

“Evidence-informed” interventions to prevent falls across the system Hospitals Real-time study- “Take 5” approach ARC Vitamin D Medication Chart review Community – RFP (4 FTE) Modified OEP (75+ & home hazard check) Model of care Funding

Falls Prevention in ARC Vitamin D evidence Collaboration between all key stakeholders Consumers Aged Residential Care Primary Care Secondary Care CDHB leadership + Planning & Funding Canterbury Clinical Network ACC Otago University School of Medicine Set target & timeframe Re-frame as real stories of “a better way”

Community Falls Champions Assess & screen for programme Strength & balance exercises in own home Home hazard check Train to increase workforce capacity Design to enable primary care integration Design to foster primary-secondary care collaboration Design a funding model to maximise quality, access and delivery of service geographically Match service to demography Reduce barriers to referrals – Health pathways

Results Delivered MOEP to over 2000 people since February 2012 Demand exceeded expectations but so has the service Vitamin D for 73% of ARC >65’s Demand on Emergency Dept Reduced 7.2% Demand on acute hospital Reduced admissions 6.9 % Hospital capacity 900 bed days saved in first year (most in last quarter)

Prevention is better than cure Are Falls Preventable in the Elderly? When does prevention start? We are responsible for the bigger picture