8 th November Community Falls Collaborative Breakfast Session

Transcription

1 8 th November 2012 Community Falls Collaborative Breakfast Session Falls Insert Breakfast name of presentation Session 8 th November on Master 2012 Slide

2 Welcome Good Morning!

3 The Falls Collaborative Structure Clinical Lead: Dr Karl Davis, Consultant Care of the Elderly Physician Cardiff and Vale University Health Board Lead Manager: Iain Roberts, Senior Service Improvement Manager, NLIAH

4 Purpose of this session The need to reduce the mortality and harm from falls The driver diagram Take up of the bundles to date Case studies Using the IHI Breakthrough Series Model. Costings work Spread beyond Wales North Wales case study

5 What do we know? What percentage of people over the age of 65 fall each year? 35% What percentage of people over the age of 80 living in the community fall each year? 45% How many people in nursing homes fall repeatedly? 60% How many calls to Welsh Ambulance are due to falls? 53,000 What is the cost to Health & Social services in Wales of people falling? 84 million per annum

6 What do we know? How many people over the age of 65 fracture their hip per year? 60,000 How many osteoporotic fractures occur in Wales each year? 12,000 What percentage of hip fractures fail to recover to their previous level of independence / mobility? 90% What percentage of older people who experience a hip fracture return to their usual place of residence? 50% What percentage of people with hip fracture die within a year? 25%

7 What do we know? Hip fracture is the commonest cause of accident related death! Falls are estimated to increase by 50% by 2020!

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9 WAST BCUHB Wrexham Elderly Rehab Unit Wrexham Exercise Referral Scheme Hywel Dda Cleddau river day hospital Withybush day hospital Tenby day hospital 1 LA residential home in Ceredigion Prince Philip A&E Glangwilli A&E Gwaun Cae Gurwen surgery - just starting ABMU Neath CIIS Neath Day Hospital Morriston A&E Coastal Housing Falls Breakfast Session 8 th November community team 2012 Powys: Brecon Day Hospital Llanidloes Day Hosptial Machynlleth Day Hospital Knighton Day Hospital Bronllys Hospital Ystradgynlais Day Hospital Brecon MIU Cwm Taf St Tydfils Day hospital Cardiff and Vale UHW A&E Barry MIU CELT Community resource team Rookwood Day hospital Barry Day Hospital Llandough Day Hospital Velindre - George Thomas Hospice Aneurin Bevan District nursing team Ebbw Vale Reablement team Newport Caerphilly CRT just starting Summer Hill Care homes with residential and nursing homes in Cardiff and Gwent

10 Bundle Implementation in Complex Settings

11 Accident and Emergency We now have evidence of reliable implementation of the trigger bundle in Accident and Emergency departments The pace of Accident and Emergency often means that staff are focussed towards the injury as opposed to the cause.

12 Cardiff UHB In Cardiff UHB Falls patients are identified on arrival in the emergency departments. Consistent screening documentation used across the Health Board. The staff undertake an initial screen of the patient. Urgent referrals are made if necessary Information on the attendance at the department is then sent out via the Communications Hub to the GP

13 Cardiff UHB 1 (i) % patients who complete the initial screening using an agreed tool Falls from Oct 2011 to Sep Oct 2011 Nov 2011 Dec 2011 Jan 2012 Feb 2012 Mar 2012 Apr 2012 May 2012 Jun 2012 Jul 2012 Aug 2012 Sep 2012 Months

14 Hywel Dda HB Accident and Emergency departments at West Wales General and Llanelli are collecting Trigger Bundle data. A service change based on regular audits of the casualty cards to determine the number of Falls presenting and whether the Fall was identified as the cause. Education programme for staff over the need to identify people who have fallen. Links to wider Community and Primary Care pathways

15 Llanelli A&E % patients who receive the full Trigger Bundle Falls from Jul 2011 to Mar Jul 2011 Aug 2011 Sep 2011 Oct 2011 Nov 2011 Months Dec 2011 Jan 2012 Feb 2012 Mar 2012

16 Llanidloes Video

17 Powys LHB - Llanidloes Been developing the model over 7 years at the hospital Believe that a majority of conditions that elder people experience will have a Falls element Built a strong reputation with local GPs Built a strong reputation with the community

18 Llanidloes Data % patients who receive the full Assessment Bundle Falls from Jun 2010 to Sep Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Months

19 IHI Breakthrough Series Model

20 7th March 2012 Falls Collaborative within Morriston A&E Dept Falls Insert Breakfast name of presentation Session 8 th November on Master 2012 Slide

21 G.P. Audit (example of audit form)

22 Falls Prevention Booklet (Front)

23 Falls Prevention Booklet (Inside)

24 SECCRT Video

25 Costing Work Work with a team in Cardiff to cost a sample of patients. Work reviewing the Dept Health Economic Evaluation of Falls Links to SAIL at Swansea University

26 Spread Beyond Wales In NHS Scotland three areas of work are planned or are underway: The development of an agreed set of Scottish community falls prevention care bundles (based on the Welsh bundles) and associated data set. Testing the implementation of the draft care bundles within one NHS board area. An evaluation of the benefits and costs of implementing the bundles. A Health Economist has commenced the evaluation, the objective of which is to quantify, for each health board and at Scotland level, the potential clinical benefits following implementation, the resources and associated costs required to implement and sustain the activities required to deliver each care bundle.

27 Spread Beyond Wales The European Innovation Partnership on Active and Healthy Ageing (EIP AHA), currently being implemented at EU level. A partnership of all relevant stakeholders to speed up the whole research/innovation chain and scaling up innovative solutions into the market for the benefit of older people and increase the quality of care. Currently being led for Wales through the office of the Older People s Commissioner

28 Great Work in North Wales! For info contact:

29 Purpose of this session has been to: Explain the need to reduce the mortality and harm from falls Explain the Driver Diagram Tell you who is using the falls bundles Tell you about some of the work of the teams Using the IHI Breakthrough Series Model Explain the Costings work Tell you about spread beyond Wales North Wales case study

30 If we can improve care for one person, then we can do it for ten. If we can do it for ten, then we can do it for a 100. If we can do it for a 100, we can do it for a 1000 And if we can do it for a 1000, we can do it for everyone in Wales.

31 Thank you