Taking a Leap Implementing the Hester Davis Fall

Taking a Leap: Implementing the Hester Davis Fall Risk Assessment Tool Susan B Schumacher, MS, APRN, CNS Methodist Hospital- Park Nicollet

Objective Discuss key strategies to effectively implement a new falls risk assessment tool.

Why Make a Change? Patient Safety Experience with falls risk assessment tool

Change Management Sustaining the change 8. Make it stick 7. Don’t let up Engaging the group or organization 6. Create short-term wins 5. Enable action 4. Communicate for buy-in Creating a climate for change 3. Get the vision right 2. Build guiding teams 1. Create a sense of urgency

It Takes a Team

Setting the Stage for Implementation Evidence on Falls Assessment Tools Evaluation of Falls Assessment Tools EPIC Development

EPIC Development • Build of HD Falls Risk Assessment Tool – linking risk factors and interventions – Interventions within flow sheet rows and Care Plan • Visual indicators (Yellow wristbands) • BPAs to support standards

Thinking in New Directions “A common mistake is prescribing interventions based on a patient’s level of risk (Low, moderate, or high), rather than tailoring interventions based on patient-specific risk factors. ” (Dykes, 2018)

Successful Plan: Variety of strategies Inter-professional approach Engagement of leaders

Education/Communication • System-wide communication • E-learning • Huddles • Newsletters • Video

Communication

Engaging Our Patients

Go-Live

Will there be Magical Changes?

Show me the Data. . . Methodist Hospital Inpatient Units Number of Falls /1, 000 patient days January, 2018 -July, 2018 4 3. 56 3. 5 Rate/1000 Patient Days 3 2. 5 2 2. 24 2. 2 1. 76 1. 59 1. 75 1. 38 1. 5 1 0. 5 0 Jan Feb March Apr Month May June July Goal = 1. 62

Falls Related to Toileting % of Falls Related to Toileting on High Impact Units January-August 2018 90% 83% 80% 75% 62% 66% Percent 60% 53% 50% 37% 40% 38% Goal (50%) 30% 20% 10% 0% Jan (n=8) Feb (n=6) Mar (n=13) Apr (n=8) Month May (n=6) June (n=8) July (n=5) August (n=8)

Key Strategy: PDCA with EPIC

Key Strategies Beyond EPIC Change Management Tactics Communication Engagement of leaders, team members and patients

It’s a Journey…