Description of the Call: Objectives: •To describe the need from a national perspective for improved quality of falls prevention processes. •To introduce the use of an audit tool and complementary data base which allows teams to collect patient level data on specific falls prevention and management quality processes. •To demonstrate how this data can be easily submitted and analyzed through the Patient Safety Metrics system and used to accelerate your quality improvement initiatives

1. APRIL 2015 IS FALLS
QUALITY AUDIT MONTH:
WHAT YOU NEED TO KNOW TO
PARTICIPATE
February 26th, 2015

2. Welcome to our francophone attendees
Bienvenue à nos participants
francophones
Hélène Riverin
Conseillère en sécurité et en amélioration
Safety Improvement Advisor

3. 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?

4. 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

5. 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

6. • 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?

7. 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.

8. 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.

9. Why focus on Falls Prevention?

10.  A basic principle of quality measurement is:
If you can’t measure it,
you can’t improve it
Why Focus on Falls Prevention &
Measurement?

11. What is Falls Prevention Quality
Audit Month?

12. 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.

13. 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

14. How often are we
doing everything
as intended?

15.  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

16. Why Should I Participate?
 Identify areas of excellence and areas for
improvement
 Measurement is critical to improve the
delivery of safe and effective healthcare

17.  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!

18.  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

19. The Falls Prevention Audit Tool

20. The Falls Prevention Audit Tool
Each horizontal line
will be for one
client/patient/resident

21. The Falls Prevention Audit Tool
Each vertical line
shows one element
of the audit tool

22. Audit Tool Fall Prevention Questions

23. Audit Tool Outcome Questions

24. Audit Tool Post Fall Questions

25. How Do I Participate?

26. 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

27. 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).

28. Registration
https://secure.e-
registernow.com/cgi-
bin/mkpayment.cgi?MID=
1527&state=step2direct&
event=500000351652040

29. 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

30.  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

31. 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. 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 form10’s
units

34. Falls Prevention Score Falls Management Score

35. 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!

36. Falls Audit Form Instructions (2 pages)

37. Accessing Instructions from PSM

38. 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

39. STEP 5 Complete the audit
Detailed instructions
are available at:
http://www.saferhealthcarenow.ca/EN/events/ot
her/FallsPreventionAudit/Pages/default.aspx

40. 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

41. Where can I find more resources for
FQA Month?

42. 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

43. Questions?

44. Please complete our poll

45. We are here to help!
For Audit forms and Data Questions
CPSI Central Measurement Team
metrics@saferhealthcarenow.ca
Virginia Flintoft - 416-946-8350
Alexandru Titeu - 416-946-3103
For Falls Content
Susan McNeill - SMcNeill@RNAO.org
Rosalie Freund - Rosalie.Freund@albertahealthservices.ca
Cheryl Henry – cheryla.henry@albertahealthservices.ca
CPSI Patient Safety Intervention Lead
Maryanne D’Arpino - MDArpino@cpsi-icsp.ca

46. We look forward to having your
organization participate in the
Canadian Falls Prevention
Quality Audit Month!
Thank you