Transcript Canadian Red Cross Ontario

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
Red Cross Background...........
Providing Home Care Services throughout the province of
Ontario since 1925. Accredited program 2003 - Present.
Our Personal Support & Homemaking Program 2010
37
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 Analysis
2010
Red Cross Client Incident Analysis
Client falls (outside of RC Service) were
the highest reported incident in 2010.
DURING RC SERVICE
508
•
•
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Falls During Service
Ambulation related activities
Mobility device (i.e. walker,
cane)
Bathroom
OUTSIDE OF RC SERVICE
3022
•
•
•
•
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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.
26
1
Current Clientele base
Frontline CSWs (PSWs)
Visiting Clinical Supervisor
1
2930 hrs
Resource/Referral Review Clinical Supervisor
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
•
•
•
•
•
•
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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.
Some CHALLENGES
of Our 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)
Service/Sector Gaps
• 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
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
SeptemberDecember 2011
RED CROSS Contact Information
Jody Hales
Manager of Client Safety & Clinical Support
[email protected]
905-328-6268