June 24th, 2014
A patient safety initiative focused on falls is on track to save more than $500,000 this year, but more important to members of the JPS fall prevention team are the patients leaving the hospital with their quality of life intact.
“A fall can forever change your life, especially if you are older,” said nurse Elisabeth Rodgers, leader of the fall prevention DSRIP project, a five-year initiative supported by $1.3 million in federal healthcare improvement funds. “We want all patients to be able to return to life as they knew it before they had to be in the hospital.”
Rodgers and her team began the project by mining electronic medical record data and conducting staff surveys and interviews to learn which patients fall, where they fall and why. They found that in the 12 months ending in June 2013, there were 632 patient falls at JPS, requiring x-rays and other diagnostic tests worth $277,646. The cost of providing sitters for fall-risk patients was more than $270,000.
Now in the third year of the project, they have piloted three successful fall prevention strategies in the patient care tower and have exceeded their initial goal of a 10 percent decline in falls. By the end of the fifth year of the project, the goal is an overall 30 percent reduction.
Yellow stars are now placed in clear view outside the rooms of patients at risk for falling, often due to altered mental status or frailty. In addition to bed alarms, the more sensitive Posey alarm is available. The Posey, for use both in beds and chairs, goes off when a patient begins to rise. Fall risk has been elevated as a top priority for discussion between nurses during shift reporting, and has been incorporated into hourly rounding.
“Given that most falls happen with patients trying to go to the restroom, a lot of the focus is on patient expectation management and intentional rounding,” said Rodgers. “If you help a patient up to use the bathroom every time you round, and the patient knows what time you will be back again, that patient is more likely to wait to get up again until you’re there to assist them.”
Future changes are to include automatic physical therapy and pharmacy consults for patients meeting specific fall-risk criteria in EPIC.
In addition to Rodgers, the fall prevention team includes Ann Bouras, David Graves, Nancy Radtke, Maryann Matis, Lou Ann Hernandez, Mary Ann Contreras, Kim Perkins, Amir Haq, Bryan Blakely and Greg Fuhrmann. Trudy Sanders and Dr. Lesca Hadley are the project’s executive and medical sponsors.
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