1. www.saferhealthcarenow.ca Rapid Fire Team Presentation Template Janine McNab Name of Presenter:

2. www.saferhealthcarenow.ca Falls Facilitated Learning Series Cambridge Memorial Hospital Our inpatient departments include: Medicine Oncology General Surgery Obstetrics Rehabilitation Mental Health Paediatrics ICU Is a community hospital with a capacity to accommodate 133 acute care patients. Located in Cambridge Ontario.

3. www.saferhealthcarenow.ca Falls Facilitated Learning Series AIM To learn and integrate strategies of sustainability into our organization’s falls improvement plans to ensure we increase the likelihood of sustaining practice change for prevention of falls and injury reduction while holding the gains over time. We will be active participants in data submission to SHN Falls Intervention and network with other enrolled teams in the National Falls Facilitated Learning Series (FFLS).

4. www.saferhealthcarenow.ca Falls Facilitated Learning Series Team Members Team Sponsor: Susan Gregoroff, Chief Nursing Executive Team Lead: Janine McNab RN, 3BPRO Team Members: Louise Chadsey RN, 3BPRO Sharon Kenkel RN, 5MED Elizabeth Wishart RN, 5MED Violette Strzelbicki RN, 5MED Rosemary Lywood Educator 3BPRO & NRT Charles Bauman, Manager 3BPRO Marlaine Cole, Manager 5MED

5. www.saferhealthcarenow.ca Falls Facilitated Learning Series A Review of Falls Change Ideas tested to date at Cambridge Memorial Hospital Changes Implemented within Organization Working/ Not Working Facilitators/Barriers Identified Yellow Arm Band Visual Identifier High Risk Patients Working Facilitator- Benefits; supports BPG Identifying high risk patients Facilitator- Attitudes, Networks Changes to Falls Prevention Policy – not just for the elderly Work in progress Barrier- Attitudes, typically low falls areas may be resistant to implementing FRA i.e. Obstetrics, Paediatrics Meditech Changes to Intervention screens Working Facilitator- Policy; removing found gaps in FRA through out the facility 4 hour Paid Falls Workshop RN, RPN, Allied Health, DI To be held end of March 2012 Facilitator- Relevance of Issue: fits with CMH strategic plan,Accreditation Canada ROP, ties in 3D’s and pharmaceuticals related to falls Facilitator- Financial: funding FRA upon transfer to a new unit/ communicating to another facility FRA Recently Implemented Facilitator- closing gaps in communication and FRA Bed/Chair Alarms trial 5MED/3BPRO ongoing trial

6. www.saferhealthcarenow.ca Falls Facilitated Learning Series Measures Falls per 1000 Patient Days

7. www.saferhealthcarenow.ca Falls Facilitated Learning Series % Falls Causing Injury Level 2 - 6

8. www.saferhealthcarenow.ca Falls Facilitated Learning Series % Admission FRA completed

9. www.saferhealthcarenow.ca Falls Facilitated Learning Series % at Risk with a Documented Falls Prevention Injury Reduction Plan

10. www.saferhealthcarenow.ca Falls Facilitated Learning Series Lessons Learned on Sustaining Falls Improvement Work during Action Period Advice to other teams: A comprehensive Falls Prevention Program involves the Interprofessional team. Falls prevention and injury reduction does not occur immediately, barriers remain despite interventions. Key Insights: Falls Prevention Programs – Will not identify all patients who will experience a fall. Should also include planning for reducing the level of injury sustained from a fall. Are not just for the older adult patient, nor are they specific only to inpatient units. FRA tools do not conform to all patient populations or all departments, multiple FRA tools may be necessary within an organization.

11. www.saferhealthcarenow.ca Falls Facilitated Learning Series What were some barriers? Financial: unknown until late December if funding available, until that point reduced hours invested in FFLS by Team Lead and Team Members. Attitudes: Ability to have Team Members present at all CMH FFLS meetings What were some Facilitators? Relevance of the issue: Impacts on Patient, Family, Health Care, part of CMH Quality Improvement Plan Political Climate: Accreditation Canada ROP, RNAO partnership in National FFLS Leadership: Supportive Organizational Leadership and Team Sponsor, committed FFLS Team; leading by example, educating and supporting as we implement sustainable changes Financial: funding through OHA/ONA Nursing Engagement- Quality Work Environment Strategy Initiative Challenges to Sustaining Falls Improvement

12. www.saferhealthcarenow.ca Falls Facilitated Learning Series Challenges to Sustaining Falls Improvement Moving Forward Education continues to be vital in sustaining change as CMH moves forward in Falls Prevention and Injury Reduction. FRA to be completed in all areas and all patient populations. A post fall process at CMH needs to be developed to have a better understanding of each individual fall and implementation of patient specific post fall care planning as part of an interprofessional, multifactorial plan.

13. www.saferhealthcarenow.ca Falls Facilitated Learning Series 6 Month Post FFLS Sustainability Plans for Falls Improvement Work Goal Description (What is AIM) Action (What STEPS are to be taken to achieve) Timeframe (When to be done by) Person Responsible Metrics: What is to be monitored to identify achievement 1-Sustaining Fall and Injury Reduction 2- Active participants in data submission to SHCN Monitoring falls dataMonthlyTo be determined Falls per 1000 patient days % Falls with injury (level) Sustaining Documentation and Intervention Changes Monitoring Falls Risk Assessment on admission, routine, PRN QuarterlyTBD % of FRA completed on admission, Sustaining and holding gains Falls audit data to be shared with Managers to present at Q&O, staff meetings, share via e-cast, post on individual units quality bulletin boards Monthly and Quarterly TBD Falls per 1000 patient days % Falls with injury (level) % FRA completed on Admission % at risk patients with Implemented standard of care plan

14. www.saferhealthcarenow.ca Falls Facilitated Learning Series 6 Month Post FFLS Sustainability Plan (continued) Goal Description (What is AIM) Action (What STEPS are to be taken to achieve) Timeframe (When to be done by) Person Responsible Metrics: What is to be monitored to identify achievement Sustaining gains made in falls reduction and practice changes Hospital Wide Orientation will include a segment on Falls prevention Start April 2012, Thereafter monthly Educators Falls per 1000 patient days % Level of injuries with falls % FRA completed on admission Sustaining ability to be active participants in Safer Health Care Now data Submission Automated electronic audit tool undeterminedLouise Bailey% FRA completed on Admission % at risk patients with falls prevention implemented care plan % patients FRA score 65 or> wearing yellow arm band

15. www.saferhealthcarenow.ca Falls Facilitated Learning Series Name: Janine McNab Email: jmcnab@cmh.org Phone Number: 519- 621-2333 ext. 3155 Contact Information