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Dundee Falls Project

Dundee Falls Project. Paul Moran Feb 2013. Today’s Presentation. Background information What is a Fall Falls statistics Projects Pathways Ninewells Accident and Emergency Pilot DIAL – OP involvement. Who I am. Physiotherapist with CRT

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Dundee Falls Project

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  1. Dundee Falls Project Paul Moran Feb 2013

  2. Today’s Presentation • Background information • What is a Fall • Falls statistics • Projects • Pathways • Ninewells Accident and Emergency Pilot • DIAL – OP involvement

  3. Who I am • Physiotherapist with CRT • Working as Dundee’s Falls Co-ordinator since 1st August 2012 • Aim • Develop a Falls Pathway • Promote Exercise/Falls Prevention

  4. Falls • “A Fall is a symptom, not a diagnosis” • The causes of Falls can be: • Extrinsic: e.g. trips and environmental hazards • Intrinsic: e.g. muscle weakness, loss of balance, impaired vision, medication related • Combination of both • Each fall is significant – a person who has fallen once is more likely to fall again!

  5. Falls Statistics • Falls are a significant cause of hospital admissions • In the UK • Fracture hip every 10 minutes • Fracture spine every 3 minutes • Fracture wrist every 5 minutes • Significantly, over 40% of those who fall reduce their activity due to fear of further falls • On average 50% of all falls occur in the persons own home • It is estimate that 75% of falls are NOT reported

  6. Dundee Statistics • In Dundee, on an annual basis • 30% of >65 years will fall (approx 8,000 people) • There were over 7,800 A&E admissions to Ninewells in 2011 as a result of a fall • 22 per day • 999 calls for Falls in Tayside (approx 3,600)

  7. Projects • Investigate Dundee’s current pathway • Stakeholder event • Test of Change • Accident and Emergency • Social Care Response • Falls Clinic referrals • Single Point of Access • Community Falls Prevention classes • OTAGO training

  8. Dundee Falls Pathway – Current State Patient Falls Ambulance Community Alarm Warden A&E See and treat First Contact Team Fracture clinic Discharge Medical wards Orthopaedics Home RVH Falls Clinic GP CRT District Nurse Psychiatry, Specialist Service Pharmacy Care Manager, Social Work If has active worker Key Blue – Health Yellow – Social Work Community support, Home Care/Enablement/Care Home

  9. Dundee Falls Pathway – Future Pathway Older Person Falls • Falls causing concerns: • Community Nurse • Community AHP • Care Worker • Community Alarm • Sheltered Housing Warden • Care Home Staff A&E Ambulance GP/Self/Carer Hospital In-patient Fracture Clinic Single Point of Access To Falls Service Triage / Sign-posting • Professional/Agency referral • Physiotherapy • Occupational Therapy • Podiatry • Pharmacy • Care and Repair • Care Management RVH Falls Clinic ExerciseOptions OTAGO Community classes C.A.N. Exercise database

  10. A&E Pilot Background • In 2011, there were 7868 attendances at A&E as a result of a fall • On average, this is 21.6 per day • In 2011, 7031 of these attendances were discharged home following assessment at A&E • In 2011, over 65’s accounted for 52% of these attendances

  11. Attendances Trend

  12. Outcome of Triage

  13. Outcome of Triage • Approximately a third of patients telephone triaged did not require any further follow up • Approximately a third were sent a Falls pack for further information • 43 were referred to physiotherapy either at Kings Cross as an outpatient, or CRT • 15 were advised to contact their GP’s with a view of further investigation • These 15 would possibly have been considered for referral to RVH Falls Clinic • A low number were referred to locality Pharmacists due to difficulties identifying appropriate patients • 4 or more medications Vs. Combinations of medications

  14. Breakdown of “Other” outcome • During the screening process 24% were already known to a service • Due to initial problems checking MiDIS and Social Work Database (K2), it would be expected that a greater number may have been known to these services.

  15. DIAL – OP Involvement • Back to original aim: • “Promote exercise and Falls prevention • Falls Pack • DIAL-OP card • Falls leaflet • Self referral form for Physiotherapy • New Falls “Magazine” • Information on services • Referral forms • Adverts

  16. DIAL – OP Involvement • Signposting • If a person has fallen direct to Single Point of access • Triage referral: Will make onward referral to appropriate service such as physiotherapy, OT, social care response, social work OT, district nurse, poly-pharmacy review” • If the person is simply looking for community exercise, please direct via the database of community exercises

  17. Contact Information • Single Point of Access is currently based at Royal Victoria Hospital • Mail: Early Intervention Hub, Royal Victoria Hospital, Jedburgh Road, Dundee, DD2 1SP • Email: dundeefallsreferral@nhs.net

  18. Any Questions ?

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