1. www.saferhealthcarenow.ca Rapid Fire Team Presentation – Royal Terrace

2. www.saferhealthcarenow.ca Falls Facilitated Learning Series Royal Terrace Palmerston, ON 67 bed Long Term Care Home Who We Are

3. www.saferhealthcarenow.ca Falls Facilitated Learning Series AIM To engage all staff of Royal Terrace in the Falls Prevention/Injury reduction policies and procedures protocol to ensure sustained improvement in reducing falls and injury from falls by implementing the educational tools learnt through the FFLS.

4. www.saferhealthcarenow.ca Falls Facilitated Learning Series Team Members Team Members:Barb Wakeford, Restorative Care Becky Wagner, RPN Diane Ash, PSW Luz Batara, PSW Luca Fleming, PSW Team Lead:Jennifer George, Director of Life Enrichment Team Sponsor:Joyce Riehle, RN

5. www.saferhealthcarenow.ca Falls Facilitated Learning Series Review Falls Change Ideas tested to date in your organization Changes Implemented within Organization Working/Not WorkingFacilitators/Barriers identified 1) Environmental Changes– layout, de-clutterWorking / OngoingFacilitator- improving area for mobility, less tripping hazards 2) Staff Education- staff information board, monthly staff meetings Working / OngoingFacilitator- visuals give staff a better perspective, allows for staff to ask questions 3) Fall Leaf Program- weekly roundsWorking / OngoingFacilitator- makes all parties aware due to visual reminders 4) In-House Physiotherapy Services- personalized treatment plans Working / OngoingFacilitator- availability of staff 7 days a week to provide treatment 5) Weekly Falls Audit- measurement toolWorking / OngoingFacilitator- data collection, analysis, graphs/statistics 6) Transfer Logos- placed above bed to identify residents transferring needs Working / OngoingFacilitator- staff awareness, at a glance reference

6. www.saferhealthcarenow.ca Falls Facilitated Learning Series Measures

7. www.saferhealthcarenow.ca Falls Facilitated Learning Series Measures

8. www.saferhealthcarenow.ca Falls Facilitated Learning Series Measures

9. www.saferhealthcarenow.ca Falls Facilitated Learning Series Measures

10. www.saferhealthcarenow.ca Falls Facilitated Learning Series Measures

11. www.saferhealthcarenow.ca Falls Facilitated Learning Series Lessons Learned on Sustaining Falls Improvement Work during Action Period What advice would you give to other teams?  Expect to have resistance from staff (poor buy-in)  Be aware of your population (cognitive impairment, increased wandering, frailty)  Be realistic when establishing goals. (SMART)  Be patient, don’t get overwhelmed “Rome wasn't built in a day” What are your key insights?  Effective & efficient communication by all stakeholders  Continuous education  Continual change with your population

12. www.saferhealthcarenow.ca Falls Facilitated Learning Series What were some barriers?  Diverse demographics  Environment (structural layout)  Staff buy-in  Staff turn-over What are some facilitators?  Excellent committee members (great commitment)  Up-to-date policies and procedures (reviewed annually) How do you propose to move forward?  By sustaining our Fall Leaf Program to achieve our goal of decreasing falls by 25% from average of 17 falls per month to 12 and an average of 2-3 falls with injury per month to 0-1 per month.  To continue to have monthly Fall Committee meetings to review collected data, analyze and make necessary changes  Keeping in compliance with Residents First and Best Practices Challenges to Sustaining Falls Improvement

13. www.saferhealthcarenow.ca Falls Facilitated Learning Series 6 Month Post FFLS Sustainability Plans for Falls Improvement Work Goal Description (What is AIM) Action (What STEPS are to be taken to achieve) Timeframe (When to be done by) Person Responsible Metrics: What is to be monitored to identify achievement Decrease the # of falls by occurring in Resident Bedroom/Bathroom by 10% a month. In conjunction to the IC3 program, staff will complete a 1 week voiding diary, then Resident will start on a prompt voiding schedule. 1 week for diary collection Prompt voiding program is ongoing once started. IC3 Committee PSW’s IC3 Committee member to check daily to ensure daily is being completed correctly. POC Charting on continence / incontinence. Decrease/eliminate the # of falls with hip injury. Registered staff to educate the benefits and encourage the purchase and use of hip protectors to family and resident upon admission. 1 week post admissionUnit Leader Charge Nurse Daily audits completed by PSW’s to ensure hip protectors are on high risk fallers and on properly.

14. www.saferhealthcarenow.ca Falls Facilitated Learning Series 6 Month Post FFLS Sustainability Plan (continued) Goal Description (What is AIM) Action (What STEPS are to be taken to achieve) Timeframe (When to be done by) Person Responsible Metrics: What is to be monitored to identify achievement To have compliant and knowledgeable staff regarding fall risks and prevention. Present statistics and data at monthly staff meeting. Post current graph and run charts on staff education board. Ongoing Director of Life Enrichment Staff’s compliancy with completing audits and falls risk assessments correctly and following Fall Risk policies and procedures. To have all Residents that are at risk for falls to actively participate in strengthening exercises 1- 3 times a week to aid in the prevention of falls. Physiotherapist will assess Resident and prescribe Resident specific exercise regimen. Within one week of admission. Physiotherapist PTA and Restorative Aide to lead strengthening exercises. Prescribed exercise will be noted in Residents Care Plan. Resident will be reassessed quarterly and changes made on care plan and noted in a progress note.

15. www.saferhealthcarenow.ca Falls Facilitated Learning Series Name: Jennifer George Email: jenniferg@wightman.ca Phone Number: 519-343-2611 ext. 227 Contact Information