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Dundee Falls Project Paul Moran Feb 2013.

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Presentation on theme: "Dundee Falls Project Paul Moran Feb 2013."— Presentation transcript:

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 “A Fall is a symptom, not a diagnosis”
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 OTAGO Community classes
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 Exercise Options 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 Month 2009 2010 2011 Jan 551 586 787 Feb 548 501 498 Mar 715 587 648 Apr 668 540 653 May 687 692 735 Jun 693 642 650 Jul 625 631 610 Aug 629 621 675 Sep 632 677 Oct 558 576 634 Nov 529 545 Dec 566 727 756 Total 7401 7277 7868

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. “Other” Number Day hospital 8 Parkinson’s clinic 5 Physiotherapy 22 Care Manager 11 Admitted 6 Repeat 4 District nurse 10 No consent 1 Audiology/ENT Liff PICU Deceased Falls clinic referral

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

18 Any Questions ?

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