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THE FOUR COSTS OF A FALL. Scott Lipps Annual Conference 2010. What we do to engage a site:. Introduction of our team Thank all attendees for their time and interest Encourage participation and eating the goodies Try to become a part of their team Stay positive
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THE FOUR COSTS OF A FALL Scott Lipps Annual Conference 2010
What we do to engage a site: • Introduction of our team • Thank all attendees for their time and interest • Encourage participation and eating the goodies • Try to become a part of their team • Stay positive • Use appropriate terms to your setting Long Term Care=F-Tags and State Surveys, MDS Acute Care=JCAHO, Quality Indicators
Introduction Over the past several weeks, we have been meeting with your management team regarding falls, your current Fall Program and fall-reduction products. Your DON (insert name) asked us to spend a few minutes with you to discuss just how serious falls are for our residents/patients, staff and facility.
Setting the Stage • First, please understand that your management team clearly recognizes that you have done a great job with the resources allocated toward fall reduction. In our meetings, we heard several times that management has asked you to do more with less and staff has responded time and time again. This meeting is solely intended to remind everyone just how serious falls are and look at the real cost of a fall. We were reminded of the old axiom, “out of sight, out of mind.” Well, we must keep falls on the radar screen looking for ways to improve procedures and reduce falls. • When you think of the term, Cost of a Fall, it is only natural to think of a dollar sign. Everything is measured in costs and in today’s economy costs are discussed everyday. The problem is, with falls, the costs are much greater than just that dollar sign. We see Four Costs to a Fall.
The Human Cost: • Falls create tremendous problems for the patient. Obviously, it hurts to fall. Look around…there are a lot of places to get hurt! Everything is wood, metal, steel and concrete with corners and edges. Often, falls are painful, cause lacerations, injuries, brain or head trauma, fractures and even, death.
The Human Cost: • Often, falls are painful, cause lacerations, injuries, brain or head trauma, fractures and even, death. • It hurts to fall. Lacerations can bleed, patients can go into shock, and injuries can be severe with fractures or worse.
The overlooked side effect: FEAR! • A fall can create fear so strong that a patient will not do their normal routines, hoping not to fall again. • These decisions lead to a lower quality of life and the “use-it-or-lose-it-syndrome.” • Fear can manifest itself in another way: After a fall, have you ever had a patient ask you not to tell their son, daughter or doctor? • “Oh, please don’t tell my family, I promised them I would ask for help, and I just forgot. I don’t want them to know I have fallen or to be mad at me.” • Or, “please don’t tell my doctor. After my last fall they changed my medication and I became confused. I didn’t really know where I was. I don’t want to go through that again…it was scary…please don’t tell on me.”
Fear changes people… • Now, we have this elegant patient, everyone liked and enjoyed, reduced to child-like pleadings to not get in trouble. That is not why patients select (insert name of facility) for their healthcare needs!
The Second Cost: Staff • Let me ask you, do you believe we are over-staffed? • Do you have free time just waiting for the next fall so you can start interviews and incident reports? • What I see and many of you have told us, is that within the first 15 minutes of your shift you are behind. Most days, you wonder how you are going to get half of the things done that you need to address. Falls add tremendous stress to our staff.
Staff feel the effects of a fall… Your management team explained to us that you have tremendous responsibilities and how hard you work to achieve them. Falls hurt our patients AND they hurt our staff. Even simple falls require time and staff attention. We must address the patient, their needs and any injuries. We must interview everyone in the area, ask questions about physical environment, and complete an incident report and contact family and physicians. Who is doing your job while all of this is taking place? You are getting farther behind and the stress is building. To make it worse, add in little things like feelings of sadness or remorse that a patient was injured on your watch or on your floor. You didn’t get into healthcare to see people injured. You have that “calling” to help others that we often discuss. Well, working at (name of facility) maybe you got into it for the big money! Falls create tremendous stress and issues for staff!
The third cost of a fall… …is that dollar sign that we talked about a few minutes ago
Money, Money, Money, Money • Yes, falls cost money! -----Big money. • Small falls cost money. • Big falls cost more money! • Falls cost the patient, family and insurance companies • Medicare/Medicaid, our facility and even YOU, money!
Falls increase the cost of care. Somebody…everybody has to pay that increased cost. The patient pays more, their family pays more, the primary funding source pays more, and costs to our facility increase. Anything that consumes the resources of (insert name of facility), detracts from the funds available for bonuses, raises and benefits! Falls start costing money from the minute they happen. TIME is expensive in health care. Falls require time. • Before we move on let’s really bring the financial cost of a fall into perspective:
Quantifying a fall… Do you know how much the average hip fracture costs? Well, most recent data says, depending on what state the injury occurs in, the average hip fracture costs $30,000! Falls are financially expensive to our entire healthcare system and economy.
The cost we all know… The Legal/Lawsuit issue. • Today, we sue everyone for everything. You know the stories: • People sue because their coffee is too hot, their child got cut from the cheerleading squad, they don’t like their boss and more. People sue everyone associated with a fall. They sue the facility, the product manufacturers and YOU!.
Lawsuits R us! I was traveling last week in Chattanooga, Tennessee and caught the late news. One of the opening commercials was an attorney asking if you had ever been scared, felt threatened or had been bitten by dog. The attorney was trying to get the viewer to find some way to sue someone related to dogs
And the story continues… The middle commercial break featured a different attorney asking about motorcycles (accidents, problems, issues, etc). Again, the attorney was prompting people to find a way to sue other people for something related to motorcycles
An easier target??? The close of the news cast featured a third commercial, by a different attorney…and this is the worst one. You have all seen it. The attorney was asking about long-term care. Do you have a loved one in a long-term care or nursing facility? Do you know how they are treated when you are not there? The attorney named a long list of problems that “may” be happening to the residents (bruises, injuries, mental and emotional abuse, sexual abuse, improper use of medications, falls, wounds, and more).
The message effects us all… The commercial made me sad for what our world has come to and mad because I know how hard people in healthcare try. Several of you are thinking that I am trying to scar you or blow this out of proportion. Sure, there are lawsuits but that happens in California and New York, not here in the Midwest.We take care of each other, bring in the mail for each other and even shovel the sidewalks for our neighbors
