Background to the improvement collaborative
The human cost of falling in hospital can be devastating and may lead to pain, injury, loss of confidence, loss of independence and increased morbidity and mortality. Falling also has an impact on quality of life. Work is well underway across hospitals to prevent serious harm to those who fall and we want to ensure providers have the information, tools and understanding to improve reporting and care.
In 2016, as part of our work to support providers to deliver the safest and best quality care to patients, we reviewed the national and international evidence on falls prevention. We then invited acute, community and mental health trusts to join a falls improvement collaborative.
19 trusts are now part of this improvement collaborative which is aiming to achieve a 5% reduction in falls rates (calculated by reported falls adjusted for under-reporting, comparing whole-year 2017/18 data with a baseline of 2016/17). We're encouraging providers to take a multi-professional focus with this as it is not only a nursing or patient safety issue.
Our aim is to support participants representing all professional groups to achieve best practice by focusing on areas that would potentially have greatest impact to improve care for this vulnerable group of patients.
Using PDSA cycles to share improvements
In the last 30 days the trusts have been completing their PDSA (plan do study act) cycles and preparing a communication to demonstrate how they will share and spread their work. The range of areas they are working on includes:
- using the bedside vision tools
- using the delirium assessment tool
- introducing safety huddles
- undertaking lying and standing blood pressure
- taking a multidisciplinary approach to falls prevention
- reviewing documentation
- increased number of medication reviews
Provider achievements so far
60 days into the improvement collaborative and there have already been some amazing achievements including:
- one trust's ward saw a 30% reduction in falls
- one trust's ward has gone 20 days without a fall - previous median number of days without a fall was 6 days