1. The Acute Rehab Unit Introduces: The Coach Caution Falls Program

2. Backround Rehab facilities’ national average falls: 7-12/1000 patient days. Rehab facilities’ national average falls: 7-12/1000 patient days. Loyola’s Rehab unit average falls: 12.8/1000 patient days (occurred in the first nine months of 2006 fiscal year). Loyola’s Rehab unit average falls: 12.8/1000 patient days (occurred in the first nine months of 2006 fiscal year). Statistics prompted the formation of a multidisciplinary committee to revise the current fall prevention program. Statistics prompted the formation of a multidisciplinary committee to revise the current fall prevention program. Goal was to have a fall rate equal to or less than 7/1000 patient days. Goal was to have a fall rate equal to or less than 7/1000 patient days.

3. Fall Data Analysis MYTH #1: Cognitively impaired patients have the highest fall rate. MYTH#2: Most patient falls occur during change of shift. FACT #1: Highest incidence of falls occur due to elimination needs. FACT#2: Patient falls occur at random times.

4. Coach Caution Fall Prevention Program Developed All Rehab Unit patients are classified as Level II protocol under Loyola’s hospital policy. All Rehab Unit patients are classified as Level II protocol under Loyola’s hospital policy. Our Rehab Unit needed to further classify patients that were fall risks. Our Rehab Unit needed to further classify patients that were fall risks. Committee developed Level III and Level IV protocols, otherwise known as “Coach Caution.”

5. Implementation of “Coach Caution” Fall Assessment every shift Fall Assessment every shift Team member signs (Level III & Level IV) Team member signs (Level III & Level IV) Player’s Guide Player’s Guide Whistle band (multi-colored vs. red) Whistle band (multi-colored vs. red) Toileting flow sheet Toileting flow sheet Bed alarm monitors Bed alarm monitors Level II protocols Level II protocols

6. Program Roll Out Fall prevention program initiated on Fall prevention program initiated on April 1 st, 2006. April 1 st, 2006. All staff was in serviced on the Coach Caution elements and their role in the program. All staff was in serviced on the Coach Caution elements and their role in the program. A short quiz given to all staff. A short quiz given to all staff.

7. Program Evaluation Five months after implementation: Five months after implementation: o Rate was 5.3 falls/1000 patient days. Nine months after implementation: Nine months after implementation: o Rate was 8.1 falls/1000 patient days.

9. Program Adjustment October 2006 showed an increase in falls and continued to trend slightly upward. October 2006 showed an increase in falls and continued to trend slightly upward. Program interventions and compliance were reviewed and adjustments were made. Program interventions and compliance were reviewed and adjustments were made. Staff was re-inserviced on the “Coach Caution” program. Staff was re-inserviced on the “Coach Caution” program. February 2007 showed a rate of 6.9 falls/1000 patient days. February 2007 showed a rate of 6.9 falls/1000 patient days.

10. Continued monitoring The Acute Rehab Unit continues to monitor the Coach Caution Falls Program through QI in order to keep our patients’ safety a priority.