Hospital Acquired Condition Affinity Series Falls with Injury Prevention 10/16/2013

1. Patient/Family Centered Safe Care: Putting Patients First Quality Improvement and Patient Safety Hospital Acquired Condition Affinity Series Falls with Injury Prevention 10/16/2013

2. Three Tools for Falls with Injury Prevention • Safe from Falls Roadmap – mnhospitals.org • Falls Reduction Template –Inpatient Setting – DoD/VA • Preventing Falls in Hospitals-AHRQ

3. What are the common elements of each? • When and how often are the patients assessed for a risk of falls • What risk assessment tools have been effective in predicting the potential for falls • What can be done universally for all patients to lower the risk of falls regardless of their risk factors. • How you can make the goal of fall reduction everyone’s responsibility

4. Safe from Falls Roadmap – mnhospitals.org • Safety Coordination –Falls Prevention Program • Team Approach • Identify an interdisciplinary group –Strategy planning/Implementation/Evaluation • Unit based falls prevention champion • Develop strategies to address special patient populations that may not score high on the risk assessment

5. Safe from Falls Roadmap – mnhospitals.org • Accurate and concurrent reporting • Data collection on all falls • Data analysis for common factors • Data analysis to determine if interventions are effective

6. Safe from Falls Roadmap – mnhospitals.org • Facility exceptions, Staff education and Accountability • Clearly communicate expectations of all hospital staff • Provide Falls Prevention Education for clinical and non-clinical staff • Administration provides resources and support for falls prevention program

7. Safe from Falls Roadmap – mnhospitals.org • Education for patient and families • Educate patients and families so informed decisions can be made and mutual goals can be established • Appropriate timing of continuing falls prevention education

8. Safe from Falls Roadmap – mnhospitals.org • Fall Risk Screening • Formal screening and re-screening all patients for fall risk • Screen outpatients for fall risk

9. Safe from Falls Roadmap – mnhospitals.org • Assessment of Risk Factors • If positive screen for fall risk, conduct in-depth clinical assessment of patient’s risk factors • Identify patients at high risk of injury from falls • Assess patient mobility status • Initiate referrals to interdisciplinary team members as appropriate (e.g. pharmacy, PT, OT) • Communicate patient high risk and mobility status as part of hand-off system

10. Safe from Falls Roadmap – mnhospitals.org • Linked Interventions • Link risk analysis findings to specific interventions to individualize fall prevention plans of care • Universal fall precautions are in place for all patients • Develop individualized care plans for patients at high-fall risk using a multi-factorial approach to preventing falls that combines interventions to increase likelihood of successful implementation • Communicate patient prevention interventions • Purposeful bedside rounding • Develop an intensified protocol to target patients post –surgery • Evaluate plan of care with interdisciplinary staff

11. Safe from Falls Roadmap – mnhospitals.org • Learn from events • Conduct Post-Fall Safety Huddles • If patient strikes head, or experiences and unwitnessed fall and shows physical signs of striking head or complains of head pain, include neuro check in post fall assessments • Revise plan of care to prevent repeat fall w/ referrals to appropriate services (fall clinic, PT, OT, etc.) as needed.

12. Safe from Falls Roadmap – mnhospitals.org • Safe Environment • Perform hospital-wide environmental safety rounds • Perform falls safety rounds for patient on individual units on a periodic basis. • Staff have easy access to equipment • Environment is modified to individualized fall risk factors (e.g. low bed, bed alarm, floor mat)

13. Questions?

14. Contact Information and Resources Safe from Falls Roadmap - http://www.mnhospitals.org/patient-safety/current-safety-quality-initiatives/falls Patient Falls Reduction Toolkit DoD -- http://health.mil/dodpatientsafety/ProductsandServices/Toolkits/PatientFallsReduction.aspx AHRQ Falls in Hospital Reduction toolkit -- http://www.ahrq.gov/professionals/systems/long-term-care/resources/injuries/fallpxtoolkit/fallpxtoolkit.pdf My contact info: Tracy Rutland trutland@gha.org 770-249-4511