Five VGH units began September poised and ready to help patients stay on their feet. Representing a mix of medicine and surgical units — Acute Care for Elders, Acute Hospitalist, Neurosciences, Subacute Medicine and Orthopaedic Surgery — this group is the first to use our new Falls Prevention Toolkit.

“More than 1,000 VGH patients fell while in care in 2012, and 47% of those falls resulted in some degree of harm,” says Tanya Dunne, program leader for regional fall and injury prevention. “Our aim is to reduce the number of falls with harm by 20 percent — and, ultimately, eliminate them. One fall is one fall too many.”

Working collaboratively with the Corporate Regional Falls Program, the VGH Falls Prevention Team, including clinical nurse educators and patient services managers, developed the Falls Prevention Toolkit of standard forms and workflows based on our new regional clinical practice guideline.

Why a toolkit is needed

Consistent with our True North goal to provide best care, falls prevention is also a Required Organizational Practice (ROP) for accreditation. In November, 2012, Accreditation Canada surveyors noted several pockets of falls prevention excellence throughout Vancouver Acute, but they also noted inconsistencies. Different units used different screening tools and processes for identifying patients at risk, and they applied different interventions to address the identified risks.

“One of our most interesting meetings,” says Megan Fekete, a clinical nurse educator in Neurosciences and a member of the Falls Prevention Team, “was when everyone brought their unit’s forms and tools to the table. A lot of us were doing similar things, but in different ways.”

By bringing the best of the best together into one cohesive package, the new Falls Prevention Toolkit helps streamline work and the patient experience.

Assess, plan and evaluate

The toolkit establishes evidence-based standard work for acute units and includes new and updated forms to accomplish:

• patient assessments for fall risk

• individualized care planning to address risk factors

• evaluation on a daily and monthly basis for ongoing improvement

“The toolkit supports our goal to be more proactive,” says Laila Aparicio, patient services manager, Neurosciences. “Going forward we’ll conduct fall screen assessments at different stages of a patient’s journey with us, including every time there’s a change of status or transfer. Regular evaluation will ensure we’re identifying problems early and then putting strategies in place to decrease the likelihood of falls.”

Each unit’s results will be displayed under their “Safety & Quality” banner and, over time, the new toolkit will be introduced across all Vancouver Acute sites. Watch for updates on implementation in upcoming issues of VCH News-Vancouver.

We thank you!

Special thanks go to our VGH Falls Prevention Team for their insights, ingenuity and involvement:

• Laila Aparicio, patient services manager, Neurosciences

• Doris Bohl, clinical nurse educator, Subacute Medicine

• Megan Fekete, clinical nurse educator, Neurosciences

• Tena Ganovicheff, patient services manager, Acute Care for Elders

• Teresa Green, practice educator, Occupational Therapy

• Jennifer Keefe, project support, Vancouver Acute

• Nureya Khimani, clinical nurse educator, Acute Medicine

• Suk Ko, patient services manager, Subacute Medicine

• Margaret Little, clinical nurse educator, Orthopaedic Surgery

• Lilibeth Ocampo, patient services manager, Orthopaedic Surgery

• Kylie Perrins, patient services manager, Acute Medicine

• Marilyn Shamatutu, clinical nurse educator, Acute Care for Elders

• Phil Sweeney, practice educator, Physiotherapy