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Dundee Falls Project Paul Moran Feb 2013. Todays Presentation Background information What is a Fall Falls statistics Projects Pathways Ninewells Accident.

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Presentation on theme: "Dundee Falls Project Paul Moran Feb 2013. Todays Presentation Background information What is a Fall Falls statistics Projects Pathways Ninewells Accident."— Presentation transcript:

1 Dundee Falls Project Paul Moran Feb 2013

2 Todays 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 Dundees Falls Co- ordinator since 1 st 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 Dundees 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 Patient Falls AmbulanceCommunity Alarm Warden A&E DischargeFracture clinic Medical wards OrthopaedicsHome RVH Falls ClinicGP CRT District Nurse First Contact Team Psychiatry, Specialist Service Pharmacy Care Manager, Social Work Community support, Home Care/Enablement/Care Home Key Blue – Health Yellow – Social Work If has active worker Dundee Falls Pathway – Current State See and treat

9 Dundee Falls Pathway – Future Pathway Older Person Falls A&EAmbulance Fracture Clinic Hospital In-patient GP/Self/Carer Falls causing concerns: Community Nurse Community AHP Care Worker Community Alarm Sheltered Housing Warden Care Home Staff Single Point of Access To Falls Service Triage / Sign-posting RVH Falls Clinic Professional/Agency referral Physiotherapy Occupational Therapy Podiatry Pharmacy Care and Repair Care Management Exercise Options OTAGO Community classesC.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 65s accounted for 52% of these attendances Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total

11 Attendances Trend

12 Outcome of Triage

13 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 GPs 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. OtherNumber Day hospital8 Parkinsons clinic5 Physiotherapy22 Care Manager11 Admitted6 Repeat4 District nurse10 No consent1 Audiology/ENT1 Liff1 PICU1 Deceased1 Falls clinic referral1

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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