Reducing the Incidence of Falls and Pressure Injuries for Older People Jane Lees ADHB

1. Reducing the Incidence of Falls and Pressure Injuries for Older People Jane Lees ADHB

2. Falls and PI Projects at ADHB September 2011: • ADHB Establishes Falls & PI Projects • Project Manager for each, both Part Time • Combined Falls & PI Steering Group • Meet Fortnightly • Main Focus on Provider • ARRC Sector mentioned but little focus

3. Falls and PI Sub Group Late 2011: • Created a Project “Sub Group” for ARRC Sector • Representatives from six ARRC facilities • Representation on Provider Steering Group • Meet every six weeks • Purpose of group • Establish Baseline Data • Establish Consistent Collection Methodology

4. ARRC Sector Costs to ADHB March 2012: • Identified cost of sector related falls within Provider • Primary Diagnosis was a Fall • Originator from a ARRC Facility • Summary of Findings • 539 falls, 469 residents (12% of total ADHB) • 70 repeat fallers within the year (15%) • $6.8 million for direct treatment, average $13k • 7325 bed days, average 14 bed days

5. ARRC Sector Wide Engagement • Held whole of Sector meeting on Falls & PI • 60+ attendees, 40+ facilities • Message: Open and Honest • regarding hospital issues collecting data • regarding numbers and costs • by providing our tools and templates

6. continued… • Discussed Falls and PI to determine • if they collect and how: • Yes, although various ways • Do they categorise • Yes, but various different methods • are they willing to share: • Yes • Discussed the best way to engage going forward…

7. Cluster Model Approach • Concept • Group the facilities into geographically based groups • Purpose: • Discussions on data collection and categorisation methods • Sharing of improvement ideas and strategies • Provide “safe” environment • Aggregate and disseminate information

8. Cluster Hosts • Asked for Volunteers from the Facilities to Host • Cluster Host Responsibilities • Provide a facility for people to meeting • Provide refreshments • Facilitate the meetings (but this can be rotated) • Good response with Hosts covering most of the Region • Build the clusters

9. Cluster Regions

10. ADHB Cluster Support ADHB will provide support to Cluster Hosts by • Providing Project Documents • Terms of Reference • Background Information • Agendas • Minutes Templates • Representative on each cluster

11. First Cluster Host Meeting First Cluster Host Meeting Held: • Agreed happy with cluster groups • Discussed Background Documentation • Discussed agenda for first meeting • Meets ADHB support people • How to collect data (email, Excel, website etc.) • Message: what’s easiest for them – be flexible

12. Collaboration Model ADHB Cluster Host Meeting Cluster Hosts (13) Cluster Meeting ARRC Facilities (68)

13. Meetings Cluster Host Meeting • Provide feedback from / about Cluster Meetings • Review data compliance • Set Agenda / theme for next meeting Cluster Meeting • Discus previous results • Issues / problems • Work through Agenda • Share solutions / ideas

14. Advantages of this Approach • Jointly driven by ADHB and ARRC Facilities • Collaborative working relationship • Consistency of approach / methodology • Develop approaches / solutions that work for everyone • Enable collaboration between facilities • Opportunity to introduce other topics in the future

15. Lessons Learnt • There is not a consistent method of collecting or categorising data • Manual vs electronic, separate vs clinical records • We don’t have the information to identify where PIs are occurring • Don’t know where to focus improvement effort • Need to collect data by facility type • Dementia, Private Hospital, Rest Home etc • 20% of ARRC Hospitalisations involve fracture of the Hip or Femur

16. Questions?