Usin

g He

alth

IT to

Impr

ove

Patie

nt

Enga

gem

ent a

nd Te

am C

omm

unic

atio

n

Patr

icia

C. D

ykes

PhD

, RN

, FAA

N, F

ACM

IRe

sear

ch P

rogr

am D

irect

orCe

nter

for P

atie

nt S

afet

y, R

esea

rch,

and

Pra

ctic

eCe

nter

for N

ursin

g Ex

celle

nce

Brig

ham

and

Wom

en’s

Hosp

ital

Asso

ciat

e Pr

ofes

sor

Harv

ard

Med

ical

Sch

ool

pdyk

es@

bwh.

harv

ard.

edu

Ove

rvie

w

•Ba

ckgr

ound

–Re

view

cur

rent

stat

e of

hea

lthca

re te

am

com

mun

icat

ion

–De

fine

patie

nt e

ngag

emen

t

•De

scrib

e a

serie

s of p

roje

cts t

hat l

ever

age

heal

th

IT to

impr

ove

team

com

mun

icat

ion,

pat

ient

en

gage

men

t, an

d pa

tient

safe

ty•

Revi

ew le

sson

s lea

rned

•Di

scus

sion

Van

Den

Bose

t. al

. (20

11) T

he $

17.1

Billi

on P

robl

em: T

he A

nnua

l Cos

t Of M

easu

rabl

e M

edic

al E

rror

s Hea

lth A

ffairs

. 30

(4) 5

96-6

03 .

Firs

t, Do

No

Harm

•In

effe

ctiv

e co

mm

unic

atio

n is

a le

adin

g ro

ot

caus

e of

med

ical

err

ors

Team

Com

mun

icat

ion

Chal

leng

es

•M

ultip

le h

ando

ffs•

Invo

lvem

ent o

f num

erou

s pro

fess

iona

l and

pa

rapr

ofes

siona

l pro

vide

rs•

Varie

d co

mm

unic

atio

n m

etho

ds

•Si

mul

tane

ous p

aral

lel c

onve

rsat

ions

•In

form

atio

n sil

os•

Inco

nsist

ent b

elie

fs re

: pat

ient

/fam

ily ro

le o

n ca

re te

am

Team

Com

mun

icat

ion

is Su

bopt

imal

: BW

H Ba

selin

e Da

ta•

Aske

d IC

U a

nd O

ncol

ogy

patie

nts (

or c

areg

iver

), be

dsid

e RN

, and

phy

sicia

n fro

m p

rimar

y te

am a

bout

th

e pa

tient

’s ov

eral

l goa

l for

hos

pita

lizat

ion

Cate

gory

N=8

8%

No.

with

1 u

niqu

e re

spon

se21

24%

No.

with

2 u

niqu

e re

spon

se44

50%

No.

with

3 u

niqu

e re

spon

se23

26%

No.

(%) o

f pat

ient

s with

X u

niqu

e re

spon

ses

Goal

s of C

are

amon

g Ho

spita

lized

Pa

tient

s (Ha

berle

2011

)

1.Be

Cur

ed2.

Live

Lon

ger

3.Im

prov

e &

Mai

ntai

n He

alth

4.Be

Com

fort

able

5.Ac

com

plish

a p

erso

nal l

ife g

oal

6.Pr

ovid

e su

ppor

t for

fam

ily7.

Oth

er

Prec

ondi

tion

for p

atie

nt-c

ente

red

care

Patie

nt A

ctiv

atio

nIn

terv

entio

ns/t

ools

desig

ned

to p

rom

ote

activ

atio

n an

d po

sitiv

e he

alth

beh

avio

rs

+

Pati

en

t En

gag

em

en

t

Hib

bard

& G

reen

(201

3). W

hat T

he E

vide

nce

Show

s Ab

out P

atient

Act

ivat

ion:

Bet

ter H

ealth

Out

com

es A

nd C

are

Expe

rienc

es; F

ewer

Dat

a O

n C

osts

Hea

lth A

ffairs

:

32 (2)

207

-214

Activ

ated

, Eng

aged

Pat

ient

s are

M

ore

likel

y to

…En

gage

in p

reve

ntiv

e be

havi

or (c

heck

-ups

, sc

reen

ings

, and

imm

uniza

tions

)

Enga

ge in

hea

lthy

beha

vior

such

(hea

lthy

diet

, reg

ular

exe

rcise

)

Avoi

d he

alth

-dam

agin

g be

havi

or (s

mok

ing

and

illeg

al d

rug

use)

Incu

r les

s cos

ts

BWH

PRO

SPEC

T P

roje

ctPr

omot

ing

Resp

ect a

nd O

ngoi

ng S

afet

y th

roug

h Pa

tient

En

gage

men

t Com

mun

icat

ion

and

Tech

nolo

gy

•Go

al: T

o tr

ansf

orm

the

inte

nsiv

e ca

re e

nviro

nmen

t thr

ough

im

plem

enta

tion

of a

pat

ient

-cen

tere

d in

terv

entio

n to

eng

age

patie

nts a

nd c

are

part

ners

in th

e pl

an o

f car

e

Supp

orte

d by

the

Moo

re F

ound

atio

n, D

W B

ates

PI

PLAN

OF

CAR

ESA

FETY

DA

SHBO

ARD

Har

ry P

otte

r

Roo

m 1

040-

A

M

RN

: 123

4567

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B: 0

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0Pl

an

of

Care

Wor

ksh

eet

Roun

ds

Chec

klist

PRO

VIDE

R

MES

SAG

ESPA

TIEN

TM

ESSA

GES

PATI

ENT

LIS

T

NOTI

FIC

ATIO

NS

48-0

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rang

er,

Her

mio

ne48

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bled

ore,

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lbus

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bled

ore,

Alb

usA

lbus

48-0

3 P

otte

r, H

arry

Har

ry P

otte

r

Mes

sage

Boa

rd

Con

vers

atio

n: P

atti,

Dr.

Dum

bled

ore,

and

Dr.

Snap

e

New

Mes

sage

C

onta

cts

Send

Send

12:3

0PM

1:00

PM

12:3

3PM

I was

revi

ewin

g m

y di

scha

rge

chec

klis

t and

thi

nk I

may

ha

ve t

roub

le p

ayin

g fo

r so

me

of th

e ne

w m

edic

atio

ns t

hat I

am

rec

eivi

ng n

ow.

Har

ry,

I will

disc

uss

durin

g th

e m

eetin

g th

is a

ftern

oon.

Will

my

prim

ary

care

doc

tor,

Dr.

Bat

es b

e av

aila

ble?

Yes,

I w

ill m

ake

ever

y ef

fort

to jo

in t

he m

eetin

g

Com

pose

a m

essa

ge…

You

Send

2 1 1

“Pat

ient

-faci

ng”

Patie

nt-C

ente

red

Tool

Kit

(PCT

K)

Com

pone

nts

“Pro

vide

r-fa

cing

”

PRO

VIDE

R FA

CIN

G TO

OLS

PRO

SPEC

T

Safe

ty C

heck

list

Mul

tidisc

iplin

ary

Plan

of C

are

Plat

form

Nur

sing

Plan

of C

are

Nur

sing

Plan

of C

are

Docu

men

tatio

n

Patie

nt P

lan

of C

are

Prob

lem

s With

In

fobu

tton

s

Patie

nt

Educ

atio

nal

Cont

ent

Clin

ical

Car

e Cl

assi

ficat

ion

Syst

em P

robl

ems a

nd

Out

com

es

Patie

nt-C

ente

red

‘Mic

robl

og’

Func

tiona

lity

Patie

nt P

orta

l: Pa

tient

send

s a m

essa

ge to

th

e ca

re te

am.

Prov

ider

Por

tal:

Care

team

can

view

and

resp

ond

usin

g‘p

atie

nt th

read

’ and

‘pro

vide

r thr

ead’

PATI

ENT

FACI

NG

TOO

LSPR

OSP

ECT

Atte

ndin

gD

r. D

alal

PC

PD

r. B

ates

Nur

seP

Dyk

es

My

Care

Team

•Im

prov

e re

spira

tory

stat

us•

Prev

ent s

kin

brea

kdow

n•

Free

of p

ain

•Ad

equa

te n

utrit

ion

Be co

mfo

rtab

le

Get o

ut o

f bed

I wou

ld li

ke m

y sis

ter t

o be

invo

lved

in m

y ca

re

Be co

mfo

rtab

le

Get o

ut o

f bed

I wou

ld li

ke m

y sis

ter t

o be

invo

lved

in m

y ca

re•Pa

in <

4•

Impr

ove

skin

inte

grity

•Te

mp

<100

.5

Be co

mfo

rtab

le

Get o

ut o

f bed

•Pa

in <<<<<<<<

4•

Impr

oooooooov•

Tem

pppp <

My

Safe

ty C

once

rns

My

Med

icat

ions

Educ

atio

n &

Tr

aini

ng

PRO

SPEC

T Re

sear

ch Q

uest

ion

and

Stud

y De

sign

Does

the

PRO

SPEC

T fra

mew

ork

posit

ivel

y im

pact

satis

fact

ion,

car

e pl

an

conc

orda

nce,

and

lead

to re

duct

ion

in a

dver

se e

vent

s and

hea

lthca

re

reso

urce

util

izatio

n an

d co

sts?

Dat

a co

llect

ion

(con

trola

nd in

terv

entio

n un

its)

Pre-

impl

emen

tatio

n Pe

riod

Post

-impl

emen

tatio

n Pe

riod

Pre-

Post

Des

ign

PRO

SPEC

T In

terv

entio

n7/

1/13

–6/

8/14

7/1/

14 –

5/29

/15

6/9/

14 –

6/30

/14

Was

h-in

Per

iod

Find

ings

*•P

atie

nt F

eedb

ack:

–“I

t’s a

real

ly g

reat

idea

. We’

re

alw

ays a

skin

g qu

estio

ns so

this

way

we

won

’t ha

ve to

cha

se

anyo

ne d

own”

–(In

resp

onse

to “M

y Ca

re Te

am

page

) “Th

ese

are

my

frie

nds!

I’ve

kn

own

them

for 7

yea

rs. I

t’s n

ice

to se

e th

eir p

ictu

res h

ere”

–“W

ith so

met

hing

like

this,

you

kn

ow w

hat’s

goi

ng o

n”

–“T

his i

s gre

at! P

atie

nts n

eed

mor

e in

fo a

bout

risk

s, sa

fety

, m

edic

atio

ns, ‘

who

is m

y do

ctor

’ ...

”

•Im

prov

ed p

atie

nt/c

are

part

ner s

atisf

actio

n

•Red

uctio

n in

adv

erse

eve

nts

•No

chan

ge in

car

e pl

an

conc

orda

nce

•No

chan

ge in

reso

urce

ut

iliza

tion

*Dyk

es P

C, R

ozen

blum

R, D

alal

A, M

assa

ro A

, Cha

ng F

, Cle

men

ts M

, Col

lins S

, Don

zeJ,

Faga

n M

, Gaz

aria

n P,

Han

na J,

Leh

man

n L,

Leo

ne K

, Lip

sitz S

, McN

ally

K, M

orris

on C

, Sa

mal

L, M

lave

rE, S

chno

ck K

, Sta

de D

, Will

iam

s D, Y

oon

C, B

ates

DW

. Pro

spec

tive

Eval

uatio

n of

a M

ultif

acet

ed In

terv

entio

n to

Impr

ove

Out

com

es in

Inte

nsiv

e Ca

re: T

he

Prom

otin

g Re

spec

t and

Ong

oing

Saf

ety

Thro

ugh

Patie

nt E

ngag

emen

t Com

mun

icat

ion

and

Tech

nolo

gy S

tudy

. Cr

itica

l Car

e M

edic

ine

2017

May

03.

PM

ID: 2

8471

886.

PRO

SPEC

T Te

am

BWH

Rese

arch

Inve

stig

ator

s

•Da

vid

Bate

s –Pr

inci

pal I

nves

tigat

or•

Sara

h Co

llins

–Co

-Inve

stig

ator

/Nur

sing

Info

rmat

ics S

peci

alist

•An

uj D

alal

–Co

-Inve

stig

ator

•Pa

tric

ia D

ykes

–Co

-Inve

stig

ator

/Dire

ctor

•Pr

iscill

a Ga

zaria

n –

Co-In

vest

igat

or•

John

Han

na –

Rese

arch

Ass

istan

t •

Jaeh

o Le

e –

Grap

hica

l Des

ign

•Li

sa L

ehm

ann

–Co

-Inve

stig

ator

•St

uart

Lips

itz –

Bios

tatis

ticia

n•

Kelly

McN

ally

–Re

sear

ch A

ssist

ant

•El

i Mla

ver –

Rese

arch

Ass

istan

t •

Conn

y M

orris

on –

Rese

arch

Ass

istan

t•

Kum

iko

Oha

shi –

Proj

ect M

anag

er•

Such

eta

Ravi

ndra

n –

Rese

arch

Ass

istan

t•

Rone

n Ro

zenb

lum

–Co

-Inve

stig

ator

•Li

pika

Sam

al –

Co-In

vest

igat

or•

Dian

a St

ade

–Re

sear

ch A

ssist

ant

•Ca

thy

Yoon

–Da

ta A

naly

st

Clin

ical

Lead

ersh

ip•

Onc

olog

y •

Ted

Alye

a –

Med

ical D

irect

or•

Eddy

Che

n –

Med

ical O

ncol

ogist

•Ka

tie F

illip

on –

Nur

sing

Dire

ctor

•M

arsh

a M

alon

e –

Nur

sing

Dire

ctor

•M

ICU

•Ka

thle

en L

eone

–N

ursin

g Di

rect

or•

Anth

ony

Mas

saro

–M

edica

l Dire

ctor

Oth

er C

olla

bora

tors

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ank

Chan

g–

Deve

lope

r•

Geor

ge G

etty

–De

velo

per

•De

bora

h W

illia

ms –

Data

base

Pro

gram

mer

•M

aure

en F

agan

–Ex

ecut

ive

Dire

ctor

for P

atie

nts a

nd

Fam

ilies

•Ca

re T

hrea

d In

c.

FALL

TIP

S (T

AILO

RIN

G IN

TERV

ENTI

ON

S FO

R PA

TIEN

T SA

FETY

)

Fall

TIPS

(Tai

lorin

g In

terv

entio

ns fo

r Pa

tient

Saf

ety)

•2

year

mix

ed m

etho

ds st

udy

fund

ed b

y Ro

bert

Woo

d Jo

hnso

n Fo

unda

tion:

–Q

ualit

ativ

e ph

ase:

•

why

hos

pita

lized

pat

ient

s fal

l?•

wha

t int

erve

ntio

ns a

re e

ffect

ive

and

feas

ible

in h

ospi

tal s

ettin

gs?

–Ra

ndom

ized

cont

rol t

rial:

to te

st a

fall

prev

entio

n to

olki

t de

signe

d to

add

ress

issu

es id

entif

ied

durin

g qu

alita

tive

phas

e.

Supp

orte

d by

the

Robe

rt W

ood

John

son

Foun

datio

n, D

ykes

PI

28

The

Fall

TIPS

Tool

kit R

equi

rem

ents

Fall

risk

Tailo

red

plan

The

Fall

TIPS

Tool

kit:

Fall

Risk

Ass

essm

ent/

Tailo

red

Plan

31

Ther

e w

ere

few

er fa

lls in

in

terv

entio

n un

its th

an in

co

ntro

l uni

ts

No

sign

ifica

nt e

ffect

was

not

ed in

fa

ll re

late

d in

jurie

s

•Fin

ding

s:–

Patie

nt fa

lls w

ere

signi

fican

tly re

duce

d on

in

terv

entio

n un

its.

Patie

nts a

ged

65 o

r old

er

bene

fited

mos

t fro

m th

e Fa

ll TI

PS to

olki

t

Fall

Prev

entio

n Le

sson

s Lea

rned

Stra

tegi

es a

nd to

ols t

o fa

cilit

ate

the

3-st

ep fa

ll pr

even

tion

proc

ess w

ill p

reve

nt p

atie

nts f

rom

falli

ng!

Fall

Prev

entio

n Le

sson

s Lea

rned

•Fa

ll TI

PS re

duce

d fa

lls b

y 25

% b

ut >

90%

of f

alls

are

prev

enta

ble…

wha

t hap

pene

d?–

Why

did

som

e pa

tient

s with

acc

ess t

o th

e Fa

ll TI

PS

Tool

kit f

all?

•

Wha

t fac

tors

are

ass

ocia

ted

with

falls

in y

oung

er p

atie

nts?

•W

hat f

acto

rs a

re a

ssoc

iate

d w

ith fa

lls in

old

er p

atie

nts?

–Se

cond

ary

anal

ysis

of fa

llers

(cas

es) n

=48

and

144

m

atch

ed co

ntro

ls ex

pose

d to

the

Fall

TIPS

tool

kit*

–

Foun

d th

at in

all

case

s, p

lann

ed in

terv

entio

ns w

ere

not f

ollo

wed

con

siste

ntly

by

the

patie

nt (m

ost

freq

uent

ly) o

r the

nur

se•

i.e.,

Out

of b

ed w

ith a

ssist

ance

How

do

we

get p

atie

nts t

o CO

NSI

STEN

TLY

follo

w th

eir f

all p

reve

ntio

n pl

an?

Dyke

s PC,

I-Chi

ng EH

, Sou

kup

JR, C

hang

F, Li

psitz

S. A

case

cont

rol s

tudy

to im

prov

e acc

urac

y of a

n ele

ctro

nic f

all pr

even

tion t

oolki

t. AM

IA A

nnu

Sym

pPro

c. 20

12; 2

012:

170-

9.

BWH

Patie

nt S

afet

y Le

arni

ng L

ab

Patie

nt-C

ente

red

Fall

Prev

entio

n To

olki

t

Prim

ary

Aim

:•

To e

ngag

e pa

tient

s and

thei

r fam

ily c

areg

iver

s as w

ell

as p

rovi

ders

in th

e de

sign

and

deve

lopm

ent o

f a fa

ll pr

even

tion

tool

kit.

This

proj

ect w

as su

ppor

ted

by g

rant

num

ber P

30HS

0235

35 fr

om th

e Ag

ency

for H

ealth

care

Res

earc

h an

d Q

ualit

y. T

he c

onte

nt is

sole

ly th

e re

spon

sibili

ty o

f th

e au

thor

s and

doe

s not

nec

essa

rily

repr

esen

t the

offi

cial

vie

ws o

f the

Age

ncy

for H

ealth

care

Res

earc

h an

d Q

ualit

y.

Mixe

d M

etho

ds/P

artic

ipat

ory

Desig

n Ap

proa

ch

•Su

rvey

s, o

bser

vatio

ns,

sem

i-st

ruct

ured

inte

rvie

ws

–N

urse

s, p

atie

nts,

fam

ilies

•In

terv

iew

s rec

orde

d, a

naly

zed

for t

hem

es•

Focu

s end

-use

r req

uire

men

ts fo

r pa

tient

par

ticip

atio

n in

3-s

tep

fall

prev

entio

n pr

oces

s•

Feed

back

on

prot

otyp

e to

ols

–El

ectr

onic

–Pa

per

Prob

lem

An

alys

is

Desig

n

Deve

lopm

ent

Impl

emen

t

Eval

uate

FALL

RIS

K AS

SESS

MEN

TEV

IDEN

CE-B

ASED

FAL

L IN

TERV

ENTI

ON

S

Fall

TIPS

Pap

er To

ol P

roto

type

Requ

irem

ent:

Valid

ate

Icon

s with

Pat

ient

s

Leun

g W

Y, Ad

elm

an J,

Bat

es D

W, B

usin

ger A

, Dyk

es JS

, Erg

aiA,

Hur

ley

A, K

atsu

lisZ,

Kho

rasa

niS,

Sca

nlan

M, S

chen

kelL

, Rai

A, D

ykes

PC.

Va

lidat

ing

Fall

Prev

entio

n Ic

ons t

o Su

ppor

t Pat

ient

-Cen

tere

d Ed

ucat

ion.

J Pa

tient

Saf

ety.

201

7 Fe

b 22

. PM

ID: 2

8230

576.

Patie

nt N

ame:

Date

: ((C

heck

all

that

app

lyly)

((Circ

le e se

lect

ion

base

d on

col

oror)

Hist

ory

of F

alls

Med

icat

ion

Side

Effe

cts

Wal

king

Aid

IV P

ole

or

Equi

pmen

t

Uns

tead

y W

alk

May

For

get o

r Ch

oose

Not

to

Call

Com

mun

icat

e Re

cent

Fal

ls

Bed

Alar

m O

n

IV A

ssist

ance

Whe

n Walk

ing

Use

Am

bula

tory

Aid

Crut

ches

Cane

Wal

ker

Toile

ting

Sche

dule

: Eve

ry _

_ ho

urs

Bed

Pan

Com

mod

e

Assi

stan

ce O

ut o

f Bed

Non

e

Bath

room

Requ

irem

ent:

Sim

plify

, add

dec

ision

supp

ort,

add

Span

ish v

ersio

n

Fall

risk

asse

ssm

ent

Tailo

red

plan

bas

ed o

n pa

tient

’s de

term

inan

ts o

f risk

Lam

inat

ed P

aper

Fal

l T.I.

P.S.

Surv

ey Q

uest

ion

Old

(N=2

7)N

ew (N

=27)

p-va

lue

Mea

nVa

rianc

eM

ean

Varia

nce

1. I

thin

k th

at I

wou

ld li

ke to

use

thes

e to

ols f

requ

ently

.2.

333

0.84

63.

704

1.21

7<.

001

2. I

find

the

tool

s unn

eces

saril

y co

mpl

ex.

3.14

81.

746

1.66

71.

077

<.00

13.

I th

ink

the

tool

s are

eas

y to

use

.2.

692

1.50

24.

222

0.94

9<.

001

4. I

thin

k th

at I

wou

ld n

eed

the

supp

ort o

f a fa

ll pr

even

tion

expe

rt to

be

able

to u

se th

ese

tool

s.1.

852

0.59

31.

500

0.66

0.1

12

5. I

find

the

vario

us fu

nctio

ns in

the

tool

s are

wel

l-in

tegr

ated

.2.

593

0.86

63.

852

1.13

1<.

001

6. I

thin

k th

ere

was

too

muc

h in

cons

iste

ncy

in

avai

labl

e to

ols.

2.70

41.

293

2.11

11.

179

.06

7. I

wou

ld im

agin

e th

at m

ost p

eopl

e w

ould

lear

n to

use

th

ese

tool

s ver

y qu

ickl

y.2.

889

1.33

34.

296

1.06

3<.

001

8. I

find

the

tool

s ver

y cu

mbe

rsom

e to

use

.3.

296

1.75

52.

222

1.87

2.0

059.

I fe

lt ve

ry c

onfid

ent u

sing

thes

e to

ols.

3.22

21.

103

4.25

91.

046

<.00

110

. I n

eede

d to

lear

n a

lot o

f thi

ngs b

efor

e I c

ould

get

go

ing

with

thes

e to

ols.

2.42

31.

134

1.85

20.

823

.04

11. I

am

sat

isfie

d w

ith th

e to

ols t

o su

ppor

t the

fall

prev

entio

n pr

oces

s at t

his h

ospi

tal.

2.48

11.

028

3.70

41.

293

<.00

1

Syst

em U

sabi

lity

Scal

e, re

spon

ses

rang

ed fr

om 1

(stro

ngly

dis

agre

e) to

5

(stro

ngly

agr

ee).

Kats

ulis

Z, E

rgai

A, L

eung

WY,

Sche

nkel

L, R

ai A

, Ade

lman

J, B

enne

yan

J, Ba

tes D

W, D

ykes

PC.

Ite

rativ

e us

er c

ente

red

desig

n fo

r dev

elop

men

t of a

pat

ient

-cen

tere

d fa

ll pr

even

tion

tool

kit.

Appl

Ergo

n. 2

016

Sep;

56:

117-

26. P

MID

: 271

8431

9.

Fall

TIPS

Pos

ter P

ilot T

est

•Ja

nuar

y –

June

201

6•

Targ

eted

uni

ts w

ith fa

ll/in

jury

rate

s abo

ve h

ospi

tal a

nd st

ate

mea

n

Site

/ N

umbe

r of U

nits

Serv

ice

Num

ber o

f Be

ds

Brig

ham

and

Wom

en’s

Hosp

ital/

3N

euro

scie

nce

Inte

rmed

iate

Car

e 43

Brig

ham

and

Wom

en’s

Hosp

ital/

2M

edic

al In

term

edia

te C

are

31

Brig

ham

and

Wom

en’s

Hosp

ital/

2O

ncol

ogy

20

Mon

tefio

re M

edic

alCe

nter

/ 1M

edic

al In

term

edia

te C

are

36

Fall

TIPS

Pilo

t Tes

t Res

ults

0102030405060708090100

0.00

1.00

2.00

3.00

4.00

5.00

6.00

Percent of Fall TIPS complete

Fallsper thousand patient days

Aver

age

Fall

Rate

201

5 vs

. 201

6 w

ith A

vera

ge F

all T

IPS

Com

plet

ion

2015

2016

Aver

age

Fall

TIPS

Com

plet

ion

Pre-

inte

rven

tion

mea

n fa

ll ra

te: 3

.28

Post

-inte

rven

tion

mea

n fa

ll ra

te: 2

.80

0102030405060708090100

0.00

0.50

1.00

1.50

2.00

2.50

Percent of Fall TIPS complete

Falls with injury per thousand patient days

Aver

age

Fall

Rate

with

Inju

ry 2

015

vs. 2

016

with

Ave

rage

Fal

l TI

PS C

ompl

etio

n

2015

2016

Aver

age

Fall

TIPS

Com

plet

ion

Pre-

inte

rven

tion

mea

n fa

ll w

ith in

jury

rat

e: 1

.00

Post

-inte

rven

tion

mea

n fa

ll w

ith in

jury

rate

: 0.5

4

Fall

TIPS

Adh

eren

ce: 8

2%

Pre-

Fall

TIPS

Fal

l Rat

e: 3

.28

Post

Fal

l TIP

S Fa

ll Ra

te: 2

.80

Pre-

Fall

TIPS

Inju

ry R

ate:

1.0

0

Post

Fal

l TIP

S In

jury

Rat

e: .5

4

In P

ress

: Dyk

es P

C, D

uckw

orth

M

, Cun

ning

ham

S, D

uboi

s S,

Drisc

oll M

, Fel

icia

no Z

, Fer

razz

i M

, Fev

rin F,

Lyon

s S, L

indr

os M

, M

onah

an A

, Pal

ey M

, Jea

n-Pi

erre

S, S

canl

an M

. Pilo

t Te

stin

g Fa

ll TI

PS (T

ailo

ring

Inte

rven

tions

for P

atie

nt

Safe

ty):

a Pa

tient

-Cen

tere

d Fa

ll Pr

even

tion

Tool

kit.

The

Join

t Co

mm

issi

on Jo

urna

l on

Qua

lity

and

Patie

nt S

afet

y. 2

017

Patie

nt-c

ente

red

Fall

Prev

entio

n To

ols

•La

min

ated

pap

er F

all T

.I.P.

S.•

Web

-bas

ed a

nd m

obile

pat

ient

por

tals

to a

cces

s Fal

l T.I.

P.S.

•

Patie

nt S

afet

y Pl

an S

cree

nsav

er fo

r pro

vide

rs

Patt

i’s P

lan

of C

are

Patie

nt P

orta

l: Fa

ll TI

PS

Patt

i’s P

lan

of C

are

Patt

i’s P

lan

of C

are

Patie

nt P

orta

l (M

obile

App

licat

ion

view

)–Fa

ll T.

I.P.S

. disp

laye

d

Patie

nt R

oom

Des

ktop

Scr

eens

aver

Patie

nt P

refe

renc

es:

Hear

ing

aid,

tran

slato

r, gl

asse

s/co

ntac

ts, l

atex

al

lerg

y, ar

m re

stric

tion

Safe

ty R

emin

ders

:Br

aden

scor

e, d

iet o

rder

, ca

thet

er in

fect

ion,

ulc

er,

rest

rain

ts, P

T ex

erci

ses e

tc

Fall

Prev

entio

n:To

iletin

g sc

hedu

le, h

elp

to

wal

k w

ith IV

Pol

e, u

se

ambu

lato

ry a

id e

tc

Patt

i’s P

lan

of C

are

Brig

ham

and

Wom

en’s

Hosp

ital

Davi

d Ba

tes

Alex

Bus

inge

rSa

rah

Colli

nsBr

ittan

y Co

utur

eAn

uj D

alal

Pa

tric

ia D

ykes

Sara

h Kh

oras

ani

Lisa

Leh

man

nEm

ily L

eung

Stua

rt L

ipsit

zEl

i Mla

ver

Rone

n Ro

zenb

lum

Je

ffrey

Sch

nipp

erKu

mik

o Sc

hnoc

k

Part

ners

Hea

lthCa

reFr

ank

Chan

gRa

mes

h Ba

pana

palli

M

ohan

Bab

u Ga

nase

kara

n Ge

nnad

y Go

rbov

itsky

Jam

es B

enne

yan

Core

y Ba

lint

Jenn

ifer C

oppo

laN

icho

las

Fasa

noZa

char

y Ka

tsul

isM

ered

ith C

lem

men

sLi

ndse

y Ba

ldo

Awat

ef E

rgai

Dom

inic

Bre

uer

Jillia

n Hi

nes

Jess

ica

Clev

elan

d

Than

k Yo

u: B

WH/

NEU

Pat

ient

Saf

ety

Lear

ning

Lab

Team

Nor

thea

ster

n In

stitu

te o

f He

alth

care

Sys

tem

s Eng

inee

ring

Patie

nt-c

ente

red

Fall

Prev

entio

nPa

tric

ia D

ykes

Emily

Leu

ngAw

atef

Erg

aiJil

lian

Hine

sZa

char

y Ka

tsul

isRa

mes

h Ba

pana

palli

M

ohan

Bab

u Ga

nase

kara

nJa

son

Adel

man

Mau

reen

Sca

nlan

Conc

lusio

ns

•M

akin

g ca

re b

ette

r: –

Will

invo

lve

part

nerin

g w

ith p

atie

nts.

–W

ill re

quire

hig

h-te

ch a

nd lo

w-te

ch so

lutio

ns•

Clin

icia

n at

titud

es st

ill h

ave

a w

ays t

o go

–W

ill b

e hi

ghly

mul

tidisc

iplin

ary

•Ro

les o

f nur

ses a

nd o

ther

clin

icia

ns w

ill c

hang

e

•He

alth

IT is

ope

ning

new

doo

rs a

nd w

e ne

ed

to ta

ke a

dvan

tage

!

Than

k yo

u

pdyk

es@

bwh.

harv

ard.

edu

49