Reducing Falls in Ward 5D and increasing days between falls How do I get sustainability once the project is complete? What’s next?

Using recognised SPSP guidelines Aim: QI Reflections Using recognised SPSP guidelines One component of a larger bundle, 95% of all patients admitted to ward 5D will have received a copy of Positive Steps booklet and their relatives invited to attend a MDT education session Ward staff open to idea and on board with Improvement methodology helped greatly Focus on one ward initially then consider other areas Time taken to progress, set up measures and find a good time to carry out tests – preparation time!

Project Measures Process measures: Number of nursing notes where it is recorded the provision of the Positive Steps booklet Number of patients who have received the Positive Steps discussion and booklet Number of carers/family invited to and attending educational sessions with staff Collation of evaluation forms from educational sessions with staff/carers

Project Measures

Changes Personalise the Positive Steps booklet for ward 5D Introduce this into the admission check-in Introduce a MDT Education session for carers/family of patients Co-ordinating all relevant staff Finding venue for education sessions and a time that suits everyone!! Staff already busy with the day job………

PDSA Cycle Data/learning/adapting Aim: Provide patient information on admission Implement new process Data/learning/adapting Cycle 6: Test all nurses/patients -1 week Cycle 5: all nurses / patients on one day Cycle 4: Test with 2nd nurse and two patients Cycle 3: Test with 2nd nurse and one patient Talk to slide – scaling up knowledge and engage other staff. Hunch/Theory: A patient leaflet given on admission will ensure relevant and helpful information on falls prevention is reliably and consistently given recorded Cycle 2: Test with one nurse and two patients Cycle 1: Test developed with one nurse and one patient

Prevention of Falls Driver Diagram Outcome Primary Drivers Use of the Model for Improvement and local data to target and drive improvement Define and collect process and outcomes data per measurement plan Communicate process and compliance measures to clinical staff and management teams staff to ensure staff knowledge and understanding of the Model for Improvement and data for improvement 25% reduction in All Falls and a 20% reduction in Falls with Harm (as defined by SPSI) by end 2015. The aim is to achieve a reduction in falls whilst promoting recovery, independence and rehabilitation. Raise awareness of issues with clinical staff – ‘make the case’ Develop, test and implement: Falls Bundle for all Patient Safety Bundle for more vulnerable patients (and all patients in care of older people wards), Multi-disciplinary Assessment and Intervention Bundle for more vulnerable patients (and all patients in care of older people wards) and Post Falls Bundle Improved clinical practice Ensure patient and family centred care Provide patient information on admission Involve Patient/Family with Care Bundles and treatment process Promote open communication among team and family Optimise transitions to home or other facility Patient and family involvement Provide a culture & infrastructure to support safety and quality improvement. Ensure executive sponsorship and clinical leadership develop and implement a staff engagement strategy establish a multi-disciplinary team to lead the work, including QI support. Raise awareness of falls bundles across the organisation optimise the physical environment. Infrastructure & Culture

My Improvement Journey so far… Best Things Hearing patients experiences and their own journey Being made welcome onto the ward Most Challenging Juggling ward routines with additional activity – shifts and consistency of staff availability Questions How do I get sustainability? Then what’s next?