falls virtual learning session # 4 closing congress team rapid fire presentation organization: red...
TRANSCRIPT
Falls Virtual Learning Session # 4 Closing Congress Team Rapid Fire Presentation
Organization: RED CROSS-ONTARIO ZONE, Home Care Sector
Speaker: Jody Hales, Manager of Client Safety & Clinical Support
Providing Home Care Services throughout the province of Providing Home Care Services throughout the province of Ontario since 1925. Accredited program 2003 - Present.Ontario since 1925. Accredited program 2003 - Present.
Red Cross Background...........
Our Personal Support & Homemaking Program 201037 Personal Support & Homemaking Programs
3358 Frontline Community Support Workers (PSWs)
113 Clinical Supervisors (RN/RPN)
Over 20,000 Clients
3.6 million Volume in hours
Red Cross Provincial Fall Event Analysis2010
Client falls (outside of RC Service) were the highest reported incident in 2010.
Red Cross Client Incident Analysis
DURING RC SERVICE
508 Falls During Service
• Ambulation related activities• Mobility device (i.e. walker,
cane)• Bathroom
OUTSIDE OF RC SERVICE
3022 Falls Outside of RC Service
• Ambulation related activities • Mobility device (i.e. walker, cane ) • Bedroom• 0600-1000hrs• After 2200hrs
Our Falls VLC Pilot Site
Peterborough Branch – Northumberland Geo Area 190 approx. Current Clientele base26 Frontline CSWs (PSWs)1 Visiting Clinical Supervisor1 Resource/Referral Review Clinical
Supervisor2930 hrs Volume per month
Falls VLC Team Members
Jody Hales, Mgr of Client Safety & Clinical Support Corporate Lead
Craig McCleary, Integrated Peterborough Branch Mgr Branch Lead
Heather Bamford, Work Safe Advisor OH&S Lead
Jaylene Eakins, Clinical Supervisor Supervisory Rep
Paula Fisher, Scheduling Centre Manager Scheduling Centre Rep
Stephanie Butson, Scheduling Coordinator Scheduling Rep
Stephen Mobe, Rob Brown, Ann Waylen, Daphne Rayner, Jaymay May, Robert Corrigan, Heather Wigmore
Frontline CSW Staff
AIM
• Reduce incidence of client (control group) fall rate by 40% from baseline by March 2011 (VLC set benchmark)
• Reduce client (control group) injury from falls by 40% from baseline by March 2011 (VLC set benchmark)
Change Ideas Tested
• Review of existing validated Falls Risk Assessment Tools
• MORSE training document for Supervisory Staff• Standardized list of Fall Intervention Strategies
(low/high risk)• Revision of our existing Home Risk Analysis form• Revision of our frontline falls training document• Revision of our Client Safety Series – Falls Prevention
document• Development of a Falls Report Tool for frontline staff
# OF CLIENTS
MEASURES (November – January 2011)
19 New Client Admissions for the VLC
19 MORSE Fall risk screening assessments completed; at referral review and again during the initial supervisory home visit. (68% identified at high risk)
19 Home Risk/Hazard report completed during new admission first PSW service visit
3 Supervisory home visits were prioritized as a result of the MORSE screening completed on referral review and the PSW Home risk/hazard report during the first PSW service visit.
13 All identified High risk clients have documented Fall intervention plans
0 No VLC client fall events occurred during this time period.
Lessons Learned to Date...
• It is of great benefit to have frontline staff involved in the process (developing/testing tools and providing feedback)
• Variance in score values when MORSE tool completed during referral review (paper review) and when MORSE tool completed at the point of care (in the client home).
• Change ideas need to be realistic and align with resources available in order to support process success.
• Falls strategy needs to be embedded into routine operational practice ..... not just another form to fill out.
CHALLENGES Uncontrolled work environment (the client home)
The client’s right to choose to live at risk
Client/family Fear - perception; ‘if I tell - I will lose my independence’ ‘If I tell - I will be taken out of my home’
Client cognitive issues
Service limitations (*we are not in the client’s home 24hrs a day)
Time and resources (workload, $$$, available health care professionals)
Some of Our Challenges...
• Structural barriers – Homecare Competitive bidding model
• Communication among service providers (what a concept)
• “Death by Assessment” Scopes of practice – Duplication of assessments/efforts between service providers
• Timely access/availability of professional in-home services - OT/PT/Social Work/Physician, etc. The right service.. the right amount.. the right time.
• Continuity of care providers for High Risk Clients – staff safety vs. client safety
Service/Sector Gaps
Next Steps
Key Sustainability Steps/Plan: Target Dates
Submission of our Falls Prevention Pilot results and developed materials with projected timeline for Provincial Roll Out
April 2011
Adaption of materials to align with other RC Community Health Service programs
2011-2012
Provincial training/roll out of New Fall Prevention Strategy
September-December 2011
Jody HalesManager of Client Safety & Clinical Support
905-328-6268
RED CROSS Contact Information