The Canterbury Health System has made great progress in reducing the harm caused by falls but it's still a major cause of harm, both in hospitals and in the community. So what are we doing about it?
Along with other District Health Boards and with the backing of the Health Quality and Safety Commission, Canterbury DHB is promoting a number of April Falls initiatives.
Susan Wood, Canterbury DHB Director Quality and Safety, says staff have been challenged to come up with clever ways to raise awareness about how to reduce the risk of a vulnerable person having a fall.
"We want staff to come up with clever and creative ways of highlighting falls as an issue, and raising awareness of how to make them less likely to happen. So far we have displays and videos. In the past we have received poems, and even songs," Susan says.
Canterbury DHB has recreated new graphics to support the falls prevention message, thanks to Waikato DHB, who shared their idea for an autumn leaves theme.
"The key message is that our ultimate aim is that nothing but leaves should fall this autumn," Susan says.
"We have also put huge effort into communicating what needs to be done to prevent harm to at-risk adults through our Releasing Time to Care bedside 'Patient Status at a Glance' Mobility Plans. Handover at the bedside and frequent checks by nurses are a really effective strategy for helping keep patients safe in our hospitals."
Ken Stewart, clinical lead for Falls Prevention in Canterbury, agrees but also stresses the importance of falls prevention initiatives in the community as part of a whole health system approach.
"We have an internationally acclaimed Community Falls Programme that makes use of referrals mainly from General Practice and the hospital to identify those most at risk in the community and connects them with a Falls Champion," Ken says.
"Many of those most at risk are frail elderly, and they aren't just more likely to fall, the consequences can be devastating to their independence – broken hips are all too common and sometimes fatal."
A Falls Champion visits a person's home to assess and help minimise home-based hazards: things like trailing cables, checking footwear has grip, securing mats or carpets, moving furniture that might be blocking where people walk most often, and increasing lighting levels.
There are other simple but less obvious actions that can help someone avoid a fall, such as placing the phone where it can be reached easily so older people don't fall hurrying to answer it, and making sure there is a light by the bed so that a person can go to the toilet safely during the night.
A Falls Champion, often a physiotherapist, will usually recommend an individually-tailored exercise routine to help build strength, balance and confidence. Over the past five years, Falls Champions have helped keep more than 6000 older Cantabrians living independently in their own homes.
"Other health professionals can help too: a pharmacist or GP team can help review medications to make sure they are taken at the right time and don't cause dizzy spells, and an optometrist can review a person's glasses prescription to make sure poor vision doesn't contribute to a fall."
Since the programme began five years ago and compared with the figures expected for people 75 and older, Canterbury has had:
Since Canterbury DHB's Older Persons Health moved to Burwood, our data shows there has also been a 22 percent reduction in falls in just the first six months, which equates to 121 fewer falls compared to the same period in previous years.
"All of our work in preventing falls, whether in hospital or at home, is part of our health system's integrated approach to reducing the risk of harm to some of our community's most vulnerable people. When combined with other initiatives to prevent avoidable injuries and manage people's health in the community our overall strategy of helping keep people well and at home is really working," Ken says.
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