1. Falls Virtual Learning Session # 4 Closing Congress Team Rapid Fire Presentation Organization: RED CROSS-ONTARIO ZONE, Home Care Sector Speaker: Jody Hales, Manager of Client Safety & Clinical Support

2. Providing Home Care Services throughout the province of Ontario since 1925. Accredited program 2003 - Present. Red Cross Background........... Our Personal Support & Homemaking Program 2010 37Personal Support & Homemaking Programs 3358Frontline Community Support Workers (PSWs) 113Clinical Supervisors (RN/RPN) Over 20,000Clients 3.6 millionVolume in hours

3. Red Cross Provincial Fall Event Analysis 2010

4. Client falls (outside of RC Service) were the highest reported incident in 2010. Red Cross Client Incident Analysis DURING RC SERVICE 508Falls During Service Ambulation related activities Mobility device (i.e. walker, cane) Bathroom OUTSIDE OF RC SERVICE 3022Falls Outside of RC Service Ambulation related activities Mobility device (i.e. walker, cane ) Bedroom 0600-1000hrs After 2200hrs

5. Our Falls VLC Pilot Site Peterborough Branch – Northumberland Geo Area 190 approx.Current Clientele base 26Frontline CSWs (PSWs) 1Visiting Clinical Supervisor 1Resource/Referral Review Clinical Supervisor 2930 hrsVolume per month

6. Falls VLC Team Members Jody Hales, Mgr of Client Safety & Clinical SupportCorporate Lead Craig McCleary, Integrated Peterborough Branch MgrBranch Lead Heather Bamford, Work Safe AdvisorOH&S Lead Jaylene Eakins, Clinical SupervisorSupervisory Rep Paula Fisher, Scheduling Centre ManagerScheduling Centre Rep Stephanie Butson, Scheduling CoordinatorScheduling Rep Stephen Mobe, Rob Brown, Ann Waylen, Daphne Rayner, Jaymay May, Robert Corrigan, Heather Wigmore Frontline CSW Staff

7. AIM Reduce incidence of client (control group) fall rate by 40% from baseline by March 2011 (VLC set benchmark) Reduce client (control group) injury from falls by 40% from baseline by March 2011 (VLC set benchmark)

8. Change Ideas Tested Review of existing validated Falls Risk Assessment Tools MORSE training document for Supervisory Staff Standardized list of Fall Intervention Strategies (low/high risk) Revision of our existing Home Risk Analysis form Revision of our frontline falls training document Revision of our Client Safety Series – Falls Prevention document Development of a Falls Report Tool for frontline staff

9. # OF CLIENTS MEASURES (November – January 2011) 19New Client Admissions for the VLC 19MORSE Fall risk screening assessments completed; at referral review and again during the initial supervisory home visit. (68% identified at high risk) 19Home Risk/Hazard report completed during new admission first PSW service visit 3Supervisory home visits were prioritized as a result of the MORSE screening completed on referral review and the PSW Home risk/hazard report during the first PSW service visit. 13All identified High risk clients have documented Fall intervention plans 0No VLC client fall events occurred during this time period.

10. Lessons Learned to Date... It is of great benefit to have frontline staff involved in the process (developing/testing tools and providing feedback) Variance in score values when MORSE tool completed during referral review (paper review) and when MORSE tool completed at the point of care (in the client home). Change ideas need to be realistic and align with resources available in order to support process success. Falls strategy needs to be embedded into routine operational practice..... not just another form to fill out.

11. CHALLENGES  Uncontrolled work environment (the client home)  The client’s right to choose to live at risk  Client/family Fear - perception; ‘if I tell - I will lose my independence’ ‘If I tell - I will be taken out of my home’  Client cognitive issues  Service limitations (*we are not in the client’s home 24hrs a day)  Time and resources (workload, $$$, available health care professionals) Some of Our Challenges...

12. Structural barriers – Homecare Competitive bidding model Communication among service providers (what a concept) “Death by Assessment” Scopes of practice – Duplication of assessments/efforts between service providers Timely access/availability of professional in-home services - OT/PT/Social Work/Physician, etc. The right service.. the right amount.. the right time. Continuity of care providers for High Risk Clients – staff safety vs. client safety Service/Sector Gaps

13. Next Steps Key Sustainability Steps/Plan:Target Dates Submission of our Falls Prevention Pilot results and developed materials with projected timeline for Provincial Roll Out April 2011 Adaption of materials to align with other RC Community Health Service programs 2011-2012 Provincial training/roll out of New Fall Prevention Strategy September- December 2011

14. Jody Hales Manager of Client Safety & Clinical Support jody.hales@redcross.ca 905-328-6268 RED CROSS Contact Information