1. Join the Falls Prevention Virtual Learning Collaborative Falls Virtual Learning Session # 4 & Closing Congress Team Rapid Fire Presentation Template Name of Organization: Labrador Grenfell Health Name of Speaker: Jan Dearing

2. Labrador-Grenfell Health Labrador-Grenfell Health provides quality acute care, long term care and home/community care services to a population just under 37,000 and covers the communities north of Bartlett’s Harbour, on the Northern Peninsula on the Island of Newfoundland, and all of Labrador. Labrador-Grenfell Health employs approximately 1570 staff and operates twenty-two facilities, including three hospitals, three community health centers, fourteen community clinics stations and two long term care facilities. Labrador-Grenfell Health is an integrated health and community services board. Who We Are

3. Team Members Team MemberRole Jan-Marie DearingRegional Quality Improvement Coordinator Beverly PittmanRegional Patient Safety Officer Colleen WheelerInpatient Unit Coordinator Janice WhiteHealth Promotion & Education Coordinator (Injury Prevention & Seniors Health) Melissa YetmanLong Term Care Coordinator Patti MooresRehabilitative Occupational Therapist

4. AIM The Purpose of our Regional Falls initiative is: To create and direct the implementation of the Labrador-Grenfell Health (LGH) Falls Prevention Strategy. By championing the issue of preventing falls across the continuum of care among patients/clients/residents of LGH, the committee strives to positively influence our surrounding physical and social environments by following a population health approach. The Principle Aims of our SHN VLC team were to: Reduce incidence of falls (fall rate) by 40% from baseline by March 2011 Reduce injury from falls by 40% from baseline by March 2011 Challenge: Choosing and implementing a falls risk assessment tool that is appropriate for the continuum of care

5. Change Ideas List Changes you have tested during Falls VLC PDSA Cycles: 1.Developed and tested Morse Fall Scale Risk Assessment tool and follow-up interventions for acute care, long term care and home/community care for a total of 45 tests across the region. Feedback was very positive and now tool is ready for roll out to all service delivery areas. 2.High risk identifier symbol – developed and in the process of completing consultations with design firm. Symbol will represent those at high risk for falling as well as the whole initiative. Will be a symbol with a very positive message.

6. Change Ideas cont’d List Changes you have tested during Falls VLC PDSA Cycles: 3. Environmental Falls Risk Assessment “Walk-Through” Checklist For Acute Care, Long Term Care, Home and Community Care developed and to be tested in April 2011. Will combine these efforts with other environmental assessments taking place in the region 4. Regional Falls Prevention power point education presentation developed and to be delivered to region in March 2011, prior to roll out of new Risk Assessment tool and follow up interventions.

7. Change Ideas cont’d List Changes you have tested during Falls VLC PDSA Cycles: 5. Hourly rounding is being implemented in our long term care facilities and departments regionally. Hourly rounding was traditionally being completed but not “officially” therefore there was not a major change in practice. The differences came with asking 3 questions of each resident at each visit and documenting once per shift that the rounding has taken place. The questions are: Do you need to go to the bathroom, Is everything within reach, and Is there anything else I can do for you? Plus the statement “I will be back in one hour” is made at the end of each visit. We predict that our falls rates will decrease; resident/family satisfaction will increase; and call bell usage will decrease. Long Term care staff, LTC Coordinator, Regional Director, residents and family are involved. Also, documentation on a flow sheet has been incorporated to reflect this change in practice.

8. LTC Measures

9. Acute Care Measures

10. Lessons Learned Lessons Learned/Key Insights 1.Large regional initiatives need not only executive support but a budget and a driver (more than one) to keep things on track and moving forward 2. PDSA cycles work! 3.Time goes by very quickly. Timeframes allotted within our implementation plans for the project initiatives need to be adjusted routinely as sometimes we are not able to accomplish what we set out to do within prescribed time

11. Lessons Learned/Key Insights 4.Need to be aware of all other projects underway in service delivery areas. It seems a simple request to ask staff to complete assessments on all new admissions but they are also being asked, by others, to do many other tasks and participate in initiatives, i.e. MDS assessments vs. Morse Fall Risk assessments and OH&S environmental assessments vs. Environmental Falls Risk Assessment “Walk-Through” Checklists. Lessons Learned cont’d

12. Next Steps Key Sustainability Steps/Plan:Target Dates Educate region about falls prevention strategy March 2011 Roll out assessment tool and follow up interventions in acute care, long term care and home care within the region April 2011 Continue meetings of steering committee and implementation of plan initiatives ongoing Audit processesJune 2011 Continue data collection and submission ongoing

13. Name: Jan-Marie Dearing RN BScN Email: jan.dearing@lghealth.ca Phone Number: (709) 897-3103 Contact Information