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APRIL 2015 IS FALLS QUALITY AUDIT MONTH:
WHAT YOU NEED TO KNOW TO PARTICIPATE
February 26th, 2015
Welcome to our francophone attendees
Bienvenue à nos participants francophones Hélène Riverin Conseillère en sécurité et en amélioration Safety Improvement Advisor
Overview
• Why focus on Falls Prevention and measurement?
• What is Falls Quality Audit month?
• Why should I participate?
• Who may participate?
• How do I participate?
• Where can I find resources for Falls month?
Today’s Speakers
Dr. Fabio Feldman PhD, Manager, Seniors Fall and Injury Prevention and Specialized Seniors Clinic
Older Adult Program
Virginia Flintoft, MSc BN, Safer Healthcare Now! Manager, Central Measurement Team
Rosalie Freund-Heritage, MScOT, AHS Project Manager, Falls ROP Project
Why Focus on Falls Prevention?
• 40-60% of residents in long-term care facilities fall at least once a year
• Approximately 10-25% of these falls result in serious injury, including up to 5% resulting in bone fractures
• The risk of sustaining a hip fracture is 10.5 times higher for women who are in facilities than if they were living in the community
• Less than 15% of residents hospitalized for hip fractures regain pre-injury ambulation status
Long-Term Care
• Falls account for up to 40% of inpatient incidents
• 30% of falls result in physical injury, with 2-5% resulting in moderate to serious injury including hip fractures or even death
• Falls can result in longer lengths of stay, increased health care cost and staff workload, and staff and family distress
• Approximately 50% of patients sustaining a in-hospital hip fracture die within one year of the fracture.
Acute Care
Why Focus on Falls Prevention?
Why Focus on Falls Prevention?
Results: Using data collected on 102 falls, they found the
average cost per fall causing an ED presentation of $11,408.
When hospitalization was required, the average cost per fall
was $29,363.
Why focus on Falls Prevention?
The average LOS for In-Hospital fall cases was 37.2 days [median 26.5
days] and 25.7 days [median 13 days] for matched control patients.
Survival analysis results indicated that patients who did not have an
In-Hospital fall were 2.4 times more likely to be discharged earlier from
acute care than patients who had a fall.
Why focus on Falls Prevention?
A basic principle of quality measurement is: If you can’t measure it,
you can’t improve it
Why Focus on Falls Prevention & Measurement?
What is Falls Prevention Quality Audit Month?
What is Falls Prevention QA Month?
The Canadian Falls Prevention Quality Audit is designed to establish a national perspective of the quality of the falls prevention processes in
place.
What is Falls Prevention QA Month?
Specific month to present metrics on quality of falls prevention
Data submitted to the Patient Safety Metrics System throughout April
Aggregate and analyze data
How often are we
doing everything
as intended?
Who? All organizations
Where? in any sector
When? throughout the month (and all year!)
What? to use measurement to support Falls
Prevention quality improvement efforts
How? Falls Prevention Quality Audit tool for acute,
long term, and home care
Participation
Why Should I Participate?
Identify areas of excellence and areas for improvement
Measurement is critical to improve the delivery of safe and effective healthcare
Partnership with RNAO, CPSI, Safer Healthcare Now! and Alberta Health Services
Development of tool over 14 months
Testing of the tool
Falls Prevention QA New this year!
Process
– 2 minutes per chart
– Simple to use
Use of data
– Reviewed monthly
– To develop their falls prevention plan
– To guide implementation
– To support sustainability
Experience of
Crowsnest Pass, Alberta
The Falls Prevention Audit Tool
The Falls Prevention Audit Tool
Each horizontal line
will be for one
client/patient/resident
The Falls Prevention Audit Tool
Each vertical line
shows one element
of the audit tool
Audit Tool Fall Prevention Questions
Audit Tool Outcome Questions
Audit Tool Post Fall Questions
How Do I Participate?
Visit the Canadian
Falls Quality Audit
webpage to get
started
http://www.saferhealt
hcarenow.ca/en/eve
nts/other/fallsprevent
ionaudit/pages/defau
lt.aspx
STEP 1 Register to participate in Falls
Prevention Quality Audit month
There is no cost to register! By registering you are committing to auditing your falls
processes and submitting your data during the month of April. Regardless of whether you are currently using the Falls
Quality Audit tool or you have never used the FQA tool, we would like all organizations to register.
Registration allows the Central Measurement team to contact you with information on how to access your site/unit-specific FQA tool(s).
All FQA audit data received in April will be included in the analysis (even if you have not registered).
Registration
https://secure.e-
registernow.com/cgi-
bin/mkpayment.cgi?MID=
1527&state=step2direct&
event=500000351652040
STEP 2 Determine the audit areas
Consider which care areas you would like to audit and how you might wish to group/analyze the
audit results. For example, would you like to collect and analyze audit data from multiple units?, across multiple
sites?, across a region?
Drill down Roll up
No specific sample size
Base sample size on patient volumes and resources available
Recommend a convenience sample of a minimum of 10 patient charts per audit area
STEP 3 Choose a sampling approach
Features:
Free, cloud-based data collection and reporting tool Available in English and French User friendly and simple to navigate Accessible from website with login details Tracks >100 process and outcome measures over 14 interventions Provides real time reporting and export of data to CSV/Excel Reduces burden of data collection, entry and analysis Roll Up or Drill Down Reports (i.e. Unit Organization Health Region
Province National) with automated Run Charts Capacity to customize measures and reports Provides real time reporting and export of data to CSV/Excel
Patient Safety Metrics - Introduction
32
Computer generated
barcode identifies
your audit area/unit
33
Need this entered on every page So we may contact you if there is an error
Date is required on every form 10’s
units
Falls Prevention Score Falls Management Score
DO … Colour inside the line - fill in bubble completely (Sharpie is best)
Avoid stacking forms when filling in bubbles to avoid bleed through
Use the void bubble for entry errors – avoid scratch out
Print new form each time - avoid photocopying
Avoid using 3-hole punch on forms
Keep form free from extra markings
Fax without a cover sheet
Fax form in FINE RESOLUTION - check setting on fax machine
Data Collection (Audit) tool- BE AWARE!
Falls Audit Form Instructions (2 pages)
Accessing Instructions from PSM
STEP 4 Access your audit tool
You can:
Use a previously generated Fall Prevention tool(s)
OR
Have the Central Measurement team assist to generate your Fall Prevention tool(s)
OR
Generate the Fall Prevention tool(s) yourself, using the Patient Safety Metrics System
STEP 5 Complete the audit
Detailed instructions are available at:
http://www.saferhealthcarenow.ca/EN/events/ot
her/FallsPreventionAudit/Pages/default.aspx
STEP 6 Submit your results
Submit your results (via fax) to the patient safety metrics system
Using a high resolution setting,
fax your audit tool to the number found
at the top of the audit tool
Where can I find more resources for FQA Month?
Resources
• Patient Safety Metrics System: https://shn.med.utoronto.ca/metrics/Login.aspx
• Falls Prevention & Management: A New Tool To Help With Process Improvement (ACUTE & LONG TERM CARE) http://www.saferhealthcarenow.ca/EN/events/NationalCalls/2015Webinars/Documents/2015-02-04%20-%20Falls/SHN%20-%20National%20Call%20-%20Falls%20Acute%20and%20LTC%20-%202015-02-04.pdf
• Falls Prevention & Management: A New Tool To Help With Process Improvement (HOME CARE) http://www.saferhealthcarenow.ca/EN/events/NationalCalls/2015Webinars/Documents/2015-02-04%20-%20Falls/SHN%20-%20National%20Call%20-%20Falls%20Home%20Care%20-%202015-02-04.pdf
Questions?
Please complete our poll
We are here to help!
For Audit forms and Data Questions
CPSI Central Measurement Team
Virginia Flintoft - 416-946-8350
Alexandru Titeu - 416-946-3103
For Falls Content
Susan McNeill - [email protected]
Rosalie Freund - [email protected]
Cheryl Henry – [email protected]
CPSI Patient Safety Intervention Lead
Maryanne D’Arpino - [email protected]
We look forward to having your
organization participate in the
Canadian Falls Prevention
Quality Audit Month!
Thank you
