Patient/Family Centered Safe Care: Putting Patients First Quality Improvement and Patient Safety Hospital Acquired Condition Affinity Series Falls with Injury Prevention 10/16/2013

Learn. Act. Improve. Spread. Keep the Drum Beat Going. 2 Three Tools for Falls with Injury Prevention Safe from Falls Roadmap – mnhospitals.org Falls Reduction Template –Inpatient Setting – DoD/VA Preventing Falls in Hospitals-AHRQ 2

Learn. Act. Improve. Spread. Keep the Drum Beat Going. 3 What are the common elements of each? When and how often are the patients assessed for a risk of falls What risk assessment tools have been effective in predicting the potential for falls What can be done universally for all patients to lower the risk of falls regardless of their risk factors. How you can make the goal of fall reduction everyone’s responsibility

Learn. Act. Improve. Spread. Keep the Drum Beat Going. 4 Safe from Falls Roadmap – mnhospitals.org S afety Coordination –Falls Prevention Program – Team Approach – Identify an interdisciplinary group –Strategy planning/Implementation/Evaluation – Unit based falls prevention champion – Develop strategies to address special patient populations that may not score high on the risk assessment 4

Learn. Act. Improve. Spread. Keep the Drum Beat Going. 5 Safe from Falls Roadmap – mnhospitals.org A ccurate and concurrent reporting – Data collection on all falls – Data analysis for common factors – Data analysis to determine if interventions are effective 5

Learn. Act. Improve. Spread. Keep the Drum Beat Going. 6 Safe from Falls Roadmap – mnhospitals.org F acility exceptions, Staff education and Accountability – Clearly communicate expectations of all hospital staff – Provide Falls Prevention Education for clinical and non-clinical staff – Administration provides resources and support for falls prevention program 6

Learn. Act. Improve. Spread. Keep the Drum Beat Going. 7 Safe from Falls Roadmap – mnhospitals.org E ducation for patient and families – Educate patients and families so informed decisions can be made and mutual goals can be established – Appropriate timing of continuing falls prevention education 7

Learn. Act. Improve. Spread. Keep the Drum Beat Going. 8 Safe from Falls Roadmap – mnhospitals.org F all Risk Screening – Formal screening and re-screening all patients for fall risk – Screen outpatients for fall risk 8

Learn. Act. Improve. Spread. Keep the Drum Beat Going. 9 Safe from Falls Roadmap – mnhospitals.org A ssessment of Risk Factors – If positive screen for fall risk, conduct in-depth clinical assessment of patient’s risk factors – Identify patients at high risk of injury from falls – Assess patient mobility status – Initiate referrals to interdisciplinary team members as appropriate (e.g. pharmacy, PT, OT) – Communicate patient high risk and mobility status as part of hand-off system 9

Learn. Act. Improve. Spread. Keep the Drum Beat Going. 10 Safe from Falls Roadmap – mnhospitals.org L inked Interventions – Link risk analysis findings to specific interventions to individualize fall prevention plans of care – Universal fall precautions are in place for all patients – Develop individualized care plans for patients at high-fall risk using a multi-factorial approach to preventing falls that combines interventions to increase likelihood of successful implementation – Communicate patient prevention interventions – Purposeful bedside rounding – Develop an intensified protocol to target patients post –surgery – Evaluate plan of care with interdisciplinary staff 10

Learn. Act. Improve. Spread. Keep the Drum Beat Going. 11 Safe from Falls Roadmap – mnhospitals.org L earn from events – Conduct Post-Fall Safety Huddles – If patient strikes head, or experiences and unwitnessed fall and shows physical signs of striking head or complains of head pain, include neuro check in post fall assessments – Revise plan of care to prevent repeat fall w/ referrals to appropriate services (fall clinic, PT, OT, etc.) as needed. 11

Learn. Act. Improve. Spread. Keep the Drum Beat Going. 12 Safe from Falls Roadmap – mnhospitals.org S afe Environment – Perform hospital-wide environmental safety rounds – Perform falls safety rounds for patient on individual units on a periodic basis. – Staff have easy access to equipment – Environment is modified to individualized fall risk factors (e.g. low bed, bed alarm, floor mat) 12

Learn. Act. Improve. Spread. Keep the Drum Beat Going. 13 Questions?

Learn. Act. Improve. Spread. Keep the Drum Beat Going. 14 Contact Information and Resources Safe from Falls Roadmap - safety/current-safety-quality-initiatives/fallshttp:// safety/current-safety-quality-initiatives/falls Patient Falls Reduction Toolkit DoD -- PatientFallsReduction.aspx PatientFallsReduction.aspx AHRQ Falls in Hospital Reduction toolkit -- care/resources/injuries/fallpxtoolkit/fallpxtoolkit.pdf care/resources/injuries/fallpxtoolkit/fallpxtoolkit.pdf My contact info: Tracy Rutland