Rapid Fire Team Presentation Julie Valiquette, Physiotherapist & Jessica Emed, Clinical Nurse Specialist

Falls Facilitated Learning Series Jewish General Hospital Montreal, Quebec Acute care hospital 637 beds Over admissions/year Affiliated with McGill University Who We Are

Falls Facilitated Learning Series AIM To engage fall prevention team members in the National Falls Facilitated Learning Series (FFLS) to work towards reducing fall rates and injuries from falls To learn and integrate strategies of sustainability into our organization's falls improvement plans To network with other enrolled teams in the FFLS program

Falls Facilitated Learning Series Team Members Team sponsors Judy Bianco, Interim Associate Nursing Director, Critical Care Services Chantal Bellerose, JGH Accreditation Coordinator & Quality Improvement Advisor Department Chiefs for Nutrition, Physiotherapy, Occupational Therapy Team leaders Julie Valiquette, Physiotherapist Jessica Emed, Clinical Nurse Specialist Team members Zeina Aoude, Dietician Helena Etrata, Nursing Education Consultant Rania Ibrahi, Occupational Therapist-Psychiatry Maya Lallouz, Physiotherapist Yanna Mentakis, Occupational Therapist Jocelyne Pépin, Pharmacist

Falls Facilitated Learning Series Falls Change Ideas tested to date in our organization Changes Implemented within Organization Working/Not WorkingFacilitators/Barriers identified New Policy and Procedure on Fall Assessment and Intervention Working Assessment and Intervention Tool in admission package WorkingF: easy access to documentation and use; includes risk assessment and individualized intervention plan Presentation of tool during general orientation to nursing staff WorkingF: increase awareness B : limited to nursing staff Reminder to fill out the tool in multidisciplinary rounds Not working yetB: only implemented on 1-2 units

Falls Facilitated Learning Series Measures 3 of the 4 in-patient units targeted for audits have shown improvements in completing fall risk assessments on admission and documenting individualized intervention plans Special attention to one unit not yet showing improvements Overall number of falls did increase slightly in the last fiscal year, may be attributed to: More complex patient population Possibility of increased reporting related to awareness-raising activities Promotion of early mobilization as much as possible

Falls Facilitated Learning Series Importance of team work and involvement of all hospital departments Importance of designated team members with protected time to work on fall prevention Importance of sustained efforts to implement changes and keep up momentum Fall prevention is a key component in patient safety Lessons Learned on Sustaining Falls Improvement Work during Action Period

Falls Facilitated Learning Series Very short time period for an institution with high turnover and a high numbers of admissions Time allowance to implement changes Given the program Given size of our institution, competing demands Some falls are very difficult to prevent (e.g., patients with mental status changes) Challenges to Sustaining Falls Improvement

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 Increase rates of assessments and intervention plans on admission Nominate a champion for each unit Designate day in the week where tools can be updated 1 monthHead nurses, Clinical Nurse Specialists and Nursing Educators Percentage of tool filled should increase Ongoing audits and feedback6 monthsResearch Assistant Introduce the Fall Prevention Policy & Procedure to new staff Mandatory hospital wide orientation to Fall Prevention 6 months Department of Training and Development in collaboration with Physiotherapy, Occupational Therapy, Nutrition Fall Prevention Committee Decrease in fall rates Increase awareness of medications that can increase fall risk Implement a visual alert on the medication administration record 3 monthsPharmacy and Nursing DepartmentsDecrease in fall rates

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 Increase awareness of clutter as a contributor to falls Organize a hospital-wide “de- clutter" contest 6 monthsFall Prevention CommitteeDecrease in fall rates Improve assessment and monitoring after a fall; help prevent recurrences Implement a post fall assessment tool and policy and procedure 6 months Nursing Department Multidisciplinary team Fall Prevention Committee Decrease in injury or injury severity; decrease in recurrences Pilot huddle meetings with multidisciplinary team to discuss circumstances of falls and changes to be implemented in care

Falls Facilitated Learning Series Julie Valiquette (514) Jessica Emed (514) ext Contact Information