Falls Reduction in a subacute

Rehabilitation Ward: Our 5 year journey

Cathy Taylor NUM

Merridie Rees CNC

Rankin Park Centre

HISTORY

The Program

• Falls marshalls

• CEC – Tools and education/ Implementation

• Govenance – guidelines

• Patient Rounding and Good communcation

• Use of Aids

• Safety huddles

• Monitoring

• Analysis

• Feedback /Review

The Journey

• RPC Falls Working Party

• CEC Falls Injury Prevention Program

• Multidisiplinary team approach to falls

reduction

• RPC under Management of JHH

• JHH Falls pilot project

Excellence Program

• Hourly patient rounding

• Bedside handover

• Staff rounding with NUM

• Rehabilitation Care Board

Mobility Terminology HNELHD adapted from CEC Poster

Alarms/ alerts

Team huddle at shift change

Falls Board and Cross

post fall- 5 whys

5 Whys Worksheet

Why is it happening?

Define the Problem:

You don’t want to list 5 different reasons; you want to go deep on 1 reason.

Why is

that?

2.

1.

3.

4.

5.

Action:

Why is

that?

Why is

that?

Why is

that?

Near miss falls

Using the Data

Average falls per month

Raw Falls Per Year 2012-2017

Where to from Here

Clinical Excellence Commission Living Better

Value Care Falls Collaborative

Our next goal is 100 days fall free

References:

• Australian Commission on Safety and Quality in Health Care (2009)

Implementation Guide for Preventing Falls and Harm from Falls in Older

People Best Practice Guidelines for Australian Hospitals and Residential

Aged Care Facilities.

• Hill, A.M., McPhail, S.M., Waldron, N., Etherton-Beer, C., Ingram, K.,

Flicker, L., Bulsara, M., Haines, T.P. (2015) Fall rates in hospital

rehabilitation units after individualised patient and staff education

programmes: at pragmatic stepped-wedge, cluster-randomised controlled

trial. The Lancet , Vol. 385, pp 2592-2599

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