Right Call for a Fall - Highlands · 2017-12-20 · Aim Increase referrals to Highland Falls...
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Aim Increase referrals to Highland Falls Pathway 30 patients per month (50%) by March 2018 Measure Number of referrals (Non Dangerous Falls >65) Non-referrals (Non Dangerous Falls >65) Patient & Staff Experience Change ASM station visits to explain the process The Highland Falls Pathway was piloted in Inverness in 2015 and spread to all other areas of the Highlands during 2016. The purpose was to identify people who had fallen (non-dangerous falls) over the age of 65 and provide the necessary follow-up falls assessment and interventions to prevent repeat falls. The single point of access, a phone call to the Highland Hub, makes it very easy to refer patients into the pathway. Despite initial success, the number of referrals into the pathway has not increased as expected during 2017 and dropped to only 4 referrals during August. The new process had not been embedded. Therefore, feedback was sought from crews to understand what was happening and why so many patients were being left at home with no onward referral. Reasons given included... u Thought that the pilot had finished u New students had never been trained u Alcohol related falls u Did not want to refer over the week-end u Some patients refuse referrals Right Call for a Fall - Highlands Reinvigorating Ambulance Referrals into the Falls Pathway by Robert Farquhar (SAS), Dr Christine McArthur (NHS Highland) Falls remains the largest category of patients conveyed to hospital, hence the priority for the Ambulance Service 1 . The next steps are... 1. Continue with ASM visits to the stations 2. Feedback to all staff in Highlands on progress towards the goal It was clear that sending bulletins by e-mail was not working. Therefore, a series of station visits was initiated in September to remind staff about the Falls Pathway and the type of patients who should be referred. Initial data shows that this has made a significant difference to the referral rate... The visits to talk to the staff in the stations appears to be having a positive effect on referrals into the Falls Pathway. However, the data shows that this has only reached 22% in September, less than halfway to the target of 50% referral of the Non Dangerous Falls >65 who were left at home. The data will be reviewed over the next few months to ensure that further action is not needed. www.scottishambulance.com 0 1600 Number of Falls 800 1200 400 All Falls 0 800 Number of Falls 400 600 200 Other Falls Non Dangerous Falls >65 0 400 Number of Falls 200 300 100 Conveyed Non-Conveyed Still in the pool 0 Number of Falls 200 300 100 Not Referred Referred 55 333 388 780 References: 1. Scottish Ambulance Service, ‘Towards 2020: Taking Care to the Patient’: A Strategic Framework for 2015-2020, February 2015, Edinburgh Scotland Only 14% referred to Falls Pathway Patients who have Fallen (2017) Patients who have Fallen (2017) Non Dangerous Falls >65 (2017) Non Dangerous Falls >65 Left at Home (2017) 1. Project Aim 2. Process Mapping North ACC and Highland Hub 3. Pareto Charts showing the Breakdown of Patients who have Fallen in the Highlands (2017) 4. Station Visits The process map shows the part of the process being worked on - where crews attend but do not convey the patient to hospital. 5. Remaining Challenge 6. Conclusions and Next Steps Signal for special cause ASM station visits started Right call for a fall Highlands.indd 1 27/10/2017 13:51
Transcript of Right Call for a Fall - Highlands · 2017-12-20 · Aim Increase referrals to Highland Falls...
Aim Increase referrals to Highland Falls Pathway 30 patients per month (50%) by March 2018
Measure Number of referrals (Non Dangerous Falls >65) Non-referrals (Non Dangerous Falls >65) Patient&StaffExperience
Change ASMstationvisitstoexplaintheprocess
The Highland Falls Pathway was piloted in Inverness in 2015 and spread to all other areas of the Highlands during 2016. The purpose was to identify people who had fallen (non-dangerous falls) over the age of 65 and provide the necessary follow-up falls assessment and interventions to prevent repeat falls. The single point of access, a phone call to the Highland Hub, makes it very easy to refer patients into the pathway.
Despite initial success, the number of referrals into the pathway has not increased as expected during 2017 and dropped to only 4 referrals during August. The new process had not been embedded. Therefore, feedback was sought from crews to understand what was happening and why so many patients were being left at home with no onward referral. Reasons given included...
u Thought that the pilot had finished u New students had never been trained u Alcohol related falls u Did not want to refer over the week-end u Some patients refuse referrals
Right Call for a Fall - HighlandsReinvigorating Ambulance Referrals into the Falls Pathwayby Robert Farquhar (SAS), Dr Christine McArthur (NHS Highland)
Falls remains the largest category of patients conveyed to hospital, hence the priority for the Ambulance Service1.
The next steps are...1. Continue with ASM visits to the stations2. Feedback to all staff in Highlands on progress towards the goal
It was clear that sending bulletins by e-mail was not working. Therefore, a series of station visits was initiated in September to remind staff about the Falls Pathway and the type of patients who should be referred. Initial data shows that this has made a significant difference to the referral rate...
The visits to talk to the staff in the stations appears to be having a positive effect on referrals into the Falls Pathway. However, the data shows that this has only reached 22% in September, less than halfway to the target of 50% referral of the Non Dangerous Falls >65 who were left at home.
The data will be reviewed over the next few months to ensure that further action is not needed.
www.scottishambulance.com
0
1600
Still
in th
e po
ol
Num
ber o
f Fal
ls
800
1200
400
All Falls0
800
Num
ber o
f Fal
ls
400
600
200
Other Falls Non Dangerous Falls >65
Still
in th
e po
ol
0
400
Num
ber o
f Fal
ls
200
300
100
Conveyed Non-Conveyed
Still
in th
e po
ol
0
Num
ber o
f Fal
ls 200
300
100
Not Referred Referred
55
333 388 780
References:1. Scottish Ambulance Service, ‘Towards 2020: Taking Care to the Patient’: A Strategic Framework for 2015-2020, February 2015, Edinburgh Scotland
Only 14% referredto Falls Pathway
Patients who have Fallen (2017) Patients who have Fallen (2017) Non Dangerous Falls >65 (2017) Non Dangerous Falls >65 Left at Home (2017)
1. Project Aim 2. Process Mapping North ACC and Highland Hub
3. Pareto Charts showing the Breakdown of Patients who have Fallen in the Highlands (2017)
4. Station Visits
The process map shows the part of the process being worked on - where crews attend but do not convey the patient to hospital.
5. Remaining Challenge 6. Conclusions and Next Steps
Signal for special cause
ASM station visits started
Right call for a fall Highlands.indd 1 27/10/2017 13:51
