Georgia Hospital Engagement Network

1. Georgia Hospital Engagement Network Hospital Acquired Condition Affinity Webinar Series 10/15/2014

2. Where we were • Quarter 1 2013 --- 1 falls with Injury per 1,587 patient day with 79 hospitals reporting • CMS Estimated cost per fall $663.00 • Total Q1-2013 Cost of falls in Georgia HEN hospitals = $234,039 • Only 32 hospitals reported “0” falls

3. What do we look like now • July 2014 – 1 Fall with Injury for ever 1,768 patient day with 93 hospitals reporting • That is 181 patient days without a fall with injury • 57 GA HEN Hospitals reported “0” Falls with Injury • 70 Hospitals have met the benchmark of 0.5/1000 • Since the baseline of the focus on Falls with Injury, • we estimate that there has been a savings of over $148,417 • 224 patient falls with injury have been prevented

4. Where could we be? • If we had made a 40% reduction from our baseline: • 479 Additional Falls with Injury could have been prevented • $317,445 in preventable cost could have been avoided • There would have been 1 fall with injury for every 2,652 patient days • That adds up to an additional 884 patient days without a fall with injury

5. Stories of Falls Prevention Champions

6. Coliseum Medical Centers Falls Analysis January – June 2014

7. Day of Week • Time of Day • Confused • Ambulation • Assistive Device • Age • Gender • Days from Admission • Toileting • Medications • Family Presence • Staffing • Risk Assessment Analyze Falls Based on Collected Data/Metrics

8. Confused Patients – 42% of falls occur from Midnight to 5 AM Alert Patients – 19.4% of falls occur between 4 AM – 7 AM. Common Peak Fall Times for both Groups: Midnight, 5 AM and 6 PM Shift Change – 20.6% of falls occur during “shift change” of 6 – 7 AM/PM. Slide 8

9. 43% = Falls related to toileting • 17% = Family was present at time of all falls • 25.4% = Patients who fell during toileting had family present at the time • Toileting/Gender: • Men = 35% of falls are associated with toileting • Women = 55% of falls are associated with toileting • Toileting / Gender/ Confusion Confused males = 25% of falls are associated with toileting Confused females = 61% of falls are associated with toileting TOILETING

10. Increased vigilance for confused patient after midnight • Mandatory “potty trips” during high risk times • Coordinate “potty times” to precede or immediately follow other activities on the unit such as laboratory phlebotomy or meal tray delivery. • Availability of bedside urinal may account for lower toileting-related falls in men. • Maintain coverage for bathroom requests during shift change • Amend Post-Fall Huddle Form to include prompts for interventions. • Mandatory Sitters after second fall Interventions

11. Slide 11 POTENTIAL IMPACT – 35% Reduction 13% Reduction: By eliminating repeat fallers 11% Reduction by convincing alert men to call for help when going to the bathroom. 11% Reduction by getting families to call for help instead of helping patients to the bathroom themselves

15. What is your Story?

16. Georgia Top Guns in Fall PreventionHospitals reporting no falls with injury since Q3-2013 (4 quarters) • Coliseum Northside Hospital • Cook Medical Center – A Campus of Tift Regional Med Center • Hutcheson Medical Center • Jefferson Hospital • SGMC Lanier Campus • Morgan Memorial Hospital • Perry Hospital • Pioneer Community Hospital of Early

17. Hospitals Reporting less than one fall with injury per month since Q2-2013 • Bacon County Hospital and Health System • Barrow Regional Medical Center • Chatuge Regional Hospital, Inc. • Chestatee Regional Hospital • Clearview Regional Med Ctr • Coliseum Medical Centers • Coliseum Northside Hospital • Colquitt Regional Medical Center • Cook Medical Center – A Campus of Tift Regional Med Center • DeKalb Medical At Hillandale • Dodge County Hospital • Effingham Health System • Elbert Memorial Hospital • Emanuel Medical Center • Hutcheson Medical Center • Evans Memorial Hospital, Inc. • Hamilton Medical Center • Houston Medical Center • Jasper Memorial Hospital • Jeff Davis Hospital • Jefferson Hospital • SGMC Lanier Campus • Miller County Hospital • Monroe County Hospital • Morgan Memorial Hospital • Murray Medical Center, Inc. • Northridge Medical Center • Perry Hospital • Phoebe Worth Medical Center • Pioneer Community Hospital of Early • Floyd Polk Medical Center • Southeast Georgia Health System Camden Campus • Southern Regional Medical Center • Southwest Georgia Regional Medical Center • Spalding Regional Medical Center • St. Francis Hospital, Inc. • St. Mary's Health Care System, Inc. • Stephens County Hospital • Ty Cobb Regional Medical Center • Upson Regional Medical Center

18. Questions or Comments?

19. Recommended Resources • Characteristics and Circumstances of Falls in a Hospital Setting http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1492485/ • AHRQ Falls Prevention Toolkit • Campaign Zero Flyer • Department of Defense Falls Prevention Toolkit • Using a Computerized Fall Risk Assessment Process to Tailor Interventions in Acute Care • Road Map to a Comprehensive Falls Prevention Program

20. Remember the Meeting Evaluation Due October 21 at 5 pm Enter Link Here

21. Contact Information Tracy Rutland trutland@gha.org 770-249-4511