Little interventions make a big impact on fall prevention
Seventeen years ago, when Suzanne Baker began her career in fall prevention, both her mother and grandmother had fallen and had broken hips.
“I watched them throughout their journey to recovery and saw the impacts that falls have on patients, their families and staff,” said Baker, the clinical coordinator of Falls Prevention in the Western Nova Scotia Health.
Falls account for at least 40 per cent of incidents in hospitals, and the length of stay for those who fall are generally three times longer. (1) This has a significant impact on the healthcare system.
Baker, a self-proclaimed lifelong learner, has degrees in Kinesiology, Education, Gerontology, and French. A large part of her role in falls prevention involves education.
“Providing staff with education around falls prevention makes them more comfortable and keeps them up to date on the best practices of how to ensure less frequent falls and less harm when they do occur,” said Baker.
Baker receives patient safety incidents which are reported electronically, and for any falls events moderate harm or higher, she connects with the manager or team lead of the area to discuss and prevent future events.
Working with a variety of healthcare teams, Baker saw the value of timely, collaborative huddles following in-hospital falls, and it inspired her latest quality improvement initiative at Fishermen’s Memorial Hospital (FMH) in Lunenburg, Nova Scotia.
Baker has expanded on this approach in her quality improvement project, Fall reduction and post fall huddles and worked with the teams on the medical, alternative levels of care, centre for restorative care, and Veteran’s units to adopt post-falls huddles in these units.
The huddles resulted in successful improvement because they are both timely, and a collaboration amongst the key teams involved.
The post fall huddle at FMS includes nursing staff, occupational therapy, physiotherapy, rehabilitation staff, and recreation therapy. They come together to review the unique situation of each patient to determine if there are any improvements that can be made, or if there is anything that can be done differently (to prevent future falls or harm).
“Bringing the teams together offer different perspectives ranging from the need for a different piece of equipment—a walker versus a cane—to where the patient should be located on the unit as part of their care plan,” explained Baker.
Timing is crucial. It’s important that huddles happen as soon as possible after the incident, so facts are remembered and documented correctly.
Baker and the team were part of the Nova Scotia Health Quality Improvement (QI) collaborative which helps staff, physicians, leaders, and patient family advisors lead quality improvement initiatives, providing the tools, resources and supports they need for the QI process.
Since implementing the initiative in January 2023 there has been a reduction in the overall number of in-hospital falls at FMS, and no falls with moderate to severe harm at the same facility.
“Fall prevention is a complex issue,” said Baker. “I think that people see falls as complicated, but there's little interventions that you can do that make big changes.”
The Fall reduction and post fall huddles initiative will continue and spread to the South Shore Regional Hospital. Work is underway to implement this on the medical unit.
Photo of Suzanne Baker, clinical coordinator of Falls Prevention in Western Nova Scotia.
(1) World Health Organization. Step safely: strategies for preventing and managing falls across the life-course. 2021