Five Hills Health Region Falls Prevention in Home Care

10-Oct-15Saskatchewan Falls Collaborative2 Background Site: Moose Jaw Union Hospital Team: Home Care and Community Therapies Patient Population: Home Health Service Clients, Team 1 and 2 Rationale: These clients receive more long term service that typically involves personal care support Higher needs client base, higher risk for falls

10-Oct-15Saskatchewan Falls Collaborative3 Aim Purpose: To decrease falls by 20% or more by March 2010 Goals/Objectives To have 100% of falls reported to Client Service Managers To establish a process to identify at risk clients To ensure that all at risk clients have falls prevention intervention Boundaries: Exclude Team 3 home services clients

Aim Challenges: -Identifying that falls have occurred -Documenting/tracking of falls reports -Communicating falls between disciplines -Implementing timely falls interventions 10-Oct-15Saskatchewan Falls Collaborative4

10-Oct-15Saskatchewan Falls Collaborative5 Team Members Home Care -Pauline Osemlak, DNS (Team Leader) -Tracey Macfarlane, RN -Corrie Hordick, HHA -Jennifer Erbach, HHA. Community Therapies -Lisa Benson, PT -Dana Philipation, PT Team Sponsor -Bert Linklater, EDCC

10-Oct-15Saskatchewan Falls Collaborative6 Results 1. BERG Score Analysis From the analysis (wilcoxon & sign tests) there is a significant difference between initial scores and FU scores.

Results 2. Falls rate per 1000 (%) 10-Oct-15Saskatchewan Falls Collaborative7

Results 3. Percentage of falls causing injury (%) 10-Oct-15Saskatchewan Falls Collaborative8

10-Oct-15Saskatchewan Falls Collaborative9 Changes Tested 1. Cards clipped to name tags: Ask these 3 questions before you leave a client’s home: Have you had a slip, trip or fall since I last saw you? Do you have your lifeline or phone with you? Do you need anything before I leave (above on the front, below on the back) Prevent Falls: Keep your clients safe in their homes! Asking these simple questions will reduce risk of falls and injury due to falls. Look for environmental hazards and encourage clients to reduce these hazards. Remember to report all falls to your supervisor.

2. Falls Records Doc Book and tracking by Client Services Managers

CLIENT NAMEDATE OF FALLLOCATION OF FALLINJURY CODE 19-Sep-11Home1 16-Sep-11Home1 04-Oct-11Daughter's home1 07-Oct-11Home2 Oct 6 & 7, 2011Home2 12-Oct-11Home; fell out of bed (side rail in place)2 06-Oct-11Slipped in shower; didn't completely fall1 20-Oct-11In home2 07-Sep 1 01-Sepfell in living room1 Oct 8-11at families in Saskatoon-fell a few times2 30-Octat home-visit to emerg2 29-Oct-11home1 Oct. 30, 2011bedroom2 25-Oct-11getting into medi chair1 01-Nov-11getting out of bed, slipped on rug1 01-Novfell in bathroom-Bentley staff helped her up1 07-Novfell in bathroom-Bentley staff helped her up1 Nov. 7fell in livingroom, missed chair1 07-Novfell in apartment, HHA arrived and sent by ambulance to hosp2 Nov 8-fell 3-4 days agofell in apartment.1 31-Octfell in apartment no injury1 Nov. 16apartment2 Nov. 20apartment1

3. Community Therapies Falls Prevention Tracking Client NameInitial Berg Score Date # of PTA visits F/U Berg ScoreDateComments

4. Community Therapies Falls Prevention Algorithm 10-Oct-15Saskatchewan Falls Collaborative13

Five Hills Health Region Community Therapy Falls Prevention Program 5. Presentations: To Home Health Aids, Moose Jaw EMS, ER department at MJUH

6. Moose Jaw EMS referral process Refer all clients with mobility impairments that you do not transport Referral process: –Write in instruction area that info has been given to Therapies –Ensure client signs form –Fax to Therapies

10-Oct-15Saskatchewan Falls Collaborative16 Lessons Learned Communication is key Need a process to deal with volume of referrals/amount of falls Falls prevention requires ongoing support from many disciplines and agencies: - Quality Improvement - Epidemiology - Primary Health Care - Home Care - Access Centre - Therapies - Physicians - EMS/ER

10-Oct-15Saskatchewan Falls Collaborative17 Next Steps Review data collection processes Formally track the volume of falls referrals to Therapies from all sources: ER, EMS, Home Care, Access Centre, inpatient wards, self/family, physicians. Connect with Primary Health Care and the Falls Steering Committee? Presentations to local physicians? How do we implement timely interventions with the same amount of staff?