1. www.saferhealthcarenow.ca Rapid Fire Team Presentation Template Name of Presenter: Dania Versailles, M.Sc.N

2. www.saferhealthcarenow.ca Falls Facilitated Learning Series Number of Patients/Residents/Clients: 300 beds; 2700 births per year; 45 000 emergency consults 1500 employees et 300 physicians. Who We Are

3. www.saferhealthcarenow.ca Falls Facilitated Learning Series AIM 20 % reduction in the fall rate; 20 % reduction in the rate of injuries from fall 100% compliance of patients with completed fall risk assessment on admission; 100 % compliance of at risk patients with a documented falls prevention plan

4. www.saferhealthcarenow.ca Falls Facilitated Learning Series Team Members Linda Lessard, Executive director quality and safety Dania Versailles, clinical nurse specialist: Team leader Madeleine Lauzon et Josée Berends, clinical educators Renée Morissette, team leader of a medecine ward Sylvie Denise Nault, clinical manager

5. www.saferhealthcarenow.ca Falls Facilitated Learning Series Review Falls Change Ideas tested to date in your organization Changes Implemented within Organization Working/Not Working + Facilitators/ - Barriers identified Mobile bed exit alarm use Working + Small gains; practical instructions Friendly and appropriate use; Availability and direct support for staff; Support from manager. Major revisions to our falls policy & procedures Working + Support from internal/external partners; Networking and awareness or outreach visits Interactive training sessions /sector (1,5-2 H) Working + Clinical educator and manager commitments; - Number of sessions,, limited resources and short-term impact on practices

6. www.saferhealthcarenow.ca Falls Facilitated Learning Series Review Falls Change Ideas tested to date in your organization Changes Implemented within Organization Working/Not Working +Facilitators/-Barriers identified Medical record audits/unit and reporting results to managers Meditech Monthly reports on falls and injuries (# falls/unit Working to provide a snapshot of current practice to managers and program lead + Promote meaningful discussions & communication; Promote staff commitment and support staff to implement care adjustments for patient. -Provide limited insights regarding root causes.

7. www.saferhealthcarenow.ca Falls Facilitated Learning Series Review Falls Change Ideas tested to date in your organization Changes Implemented within Organization StatusFacilitators/Barriers identified Monthly workgroup meetings  +Provides a regular forum to exchange information and make decisions Meeting with Quality medicine team: Action plan 2012; Target: November 2012; Posters for patients’ washrooms.  + Mobilization of additional resources; Best momentum for sustainability Changes Implemented within Organization Working/Not WorkingFacilitators/Barriers identified Monthly workgroup meetings Working +Provides a regular forum to exchange information and make decisions Meeting with medicine’s Quality team: Action plan 2012;Target: November 2012; Posters for patients’ washrooms (approved mi- Feb & purchased) Not yet known + Support from other key stakeholders & departments + Involvement of additional resources; + Optimal opportunity to integrate sustainability initiatives

8. www.saferhealthcarenow.ca Falls Facilitated Learning Series Review Falls Change Ideas tested to date in your organization Changes in progress within Organization Working/Not Working +Facilitators/ -Barriers identified Create a reference binder (paper and electronic formats) Working (anticipated) +Tools box; +Restraint alternatives; +Decision tree post-fall +SBARR communication worksheet - Limited available resources E-documentation project (Meditech screens revised for Morse scale, restraint) Working +Support from short term project; Led by nurse with IT expertise and team composed of front-line staff Development of a business plan for purchase of integrated bed exit alarm Working (approved) + Supported by 3 directors, technical services, purchasing services and working group

9. www.saferhealthcarenow.ca Falls Facilitated Learning Series Measures Any measurement you have related to your AIM Audits of medical records and reporting results: Injury rate from July to Dec 2011: 30% to 18%. Audit show an increase completed Morse scale from 35% to 65% on a medicine floor 100% of at-risk patients had selected interventions documented Meditech reports (# Falls number and injuries/unit/month); Feedback of working group members and employees: “Great that we are working on the solutions and practical tools for patients and staff” Number of strategies implemented: 11

10. 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?  The PDSA are very important;  Keep the champions and teams involved, informed of the activities;  Use existing standards & expectations as leverage (Accreditation Canada, organizational mission and strategic plan) as parts of accountability;  Create a supportive environment aligned with objectives and additional activities What are your key insights?  Visibility, presence and involvement of the team for the fall prevention program; Partnerships and networking at various levels (internal and external)

11. www.saferhealthcarenow.ca Falls Facilitated Learning Series What were some barriers? Competing priorities Unavailability of existing resources Limited or no access evaluation tools and decision-aids What are some facilitators? Support from management representatives (middle and upper) Inter-professional and multi-departmental collaboration How do you propose to move forward? Focus on fewer initiatives at a time, integrate RCA and FMEA-type of aids Challenges to Sustaining Falls Improvement

12. 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 Expand interventions’ set in documentation screen for falls and alternatives to restraints Convene a sub-workgroup who will: Make an inventory of causes of falls, by categories Identify solutions to prevent or protect patients from falls Integrate them in Meditech & in practice, and follow-up May 1 st 2012Dania Versailles # of currently available interventions # of new available interventions % of use of new interventions for at- risk patients # Audits on units to validate reliability of documented interventions. Staff feedback Communicate regularly to stakeholders Obtain a list of expanded communication strategies Formulate and implement an integrated communication plan Evaluate outcomes for readjustments September 1 st 2012 Dania Versailles# of communications submitted # of people involved (authors/ speakers, local leaders) # of visual aids posted/distributed # of written dcuments produced

13. 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 Post-fall management will become standardized, and efficient Provide copies of SBARR falls worksheet on units Orient/coach staff regarding its use March 30th 2012 Dania Versailles & other nurse educators Satisfaction or feedback surveys (nursing staff, physician, OT, PT) Focus group discussion Have the reference binder accessible to staff on intranet Submit content electronically to webmaster coordinator March 30 th 2012 Dania VersaillesElectronic binder is accessible on the intranet # of hits Participate in the customization of a new web-based incident reporting tool. Submit an interest to participate to ensure falls- specific data will be considered and ensure user-friendliness September 30 th 2012 Dania Versailles and other members of the workgroup Consulted # of consultations # of tests completed Stakeholder feedback Offer eudcational sessions and outreach visits Review content as necessary Deliver sessions/visits July 15 th 2012Dania VersaillesParticipant feedback

14. www.saferhealthcarenow.ca Falls Facilitated Learning Series Name: Dania Versailles, clinical nurse specialist Email: dversailles@montfort.on.ca Phone Number: 613-746-4621, ext:3706 Contact Information