1. Community Falls Prevention in Canterbury Keeping Les & Gloria upright at home
Ken Stewart
Canterbury DHB Falls Prevention Clinical Lead
HQSC Falls Expert Advisory Group
May 2013
Intro
Community based funding and delivery model setup and RFP pending
put together a performance improvement model that delivers on our CCN targets and is within budget
we looked at historical, current and potential issues strategically rather than scripting contracts for clinicians as this approach needs to evolve based upon issues as they arise in next 12 months particularly
This also needs to be an effective engagement strategy for all clinicians across the system
We have designed a funding and delivery model to provide a sustainable OEP type programme and a SOYF programme for Cantabrians

3. Where were we 2 years ago?
CDHB Clinical Board recognised falls were a problem in our hospitals
Recognised impact of falls upon frail elderly in all settings
Hospitals –stories from RCA’s + whole system
Aged Residential Care
Community
We gathered data for falls in all of these areas
We reviewed the evidence for reducing harm from falls to match our aim of Zero Harm

4. “Evidence-informed” interventions to prevent falls across the system
Hospitals
Real-time study- “Take 5” approach
ARC
Vitamin D
Medication Chart review
Community – RFP (4 FTE)
Modified OEP (75+ & home hazard check)
Model of care
Funding

5. Falls Prevention in ARC
Vitamin D evidence
Collaboration between all key stakeholders
Consumers
Aged Residential Care
Primary Care
Secondary Care
CDHB leadership + Planning & Funding
Canterbury Clinical Network
ACC
Otago University School of Medicine
Set target & timeframe
Re-frame as real stories of “a better way”

6. Community Falls Champions
Assess & screen for programme
Strength & balance exercises in own home
Home hazard check
Train to increase workforce capacity
Design to enable primary care integration
Design to foster primary-secondary care collaboration
Design a funding model to maximise quality, access and delivery of service geographically
Match service to demography
Reduce barriers to referrals – Health pathways

7. Results Delivered MOEP to over 2000 people since February 2012
Demand exceeded expectations but so has the service
Vitamin D for 73% of ARC >65’s
Demand on Emergency Dept
Reduced 7.2%
Demand on acute hospital
Reduced admissions 6.9 %
Hospital capacity
900 bed days saved in first year (most in last quarter)

8. Prevention is better than cure
Are Falls Preventable in the Elderly?
When does prevention start?
We are responsible for the bigger picture