The programme

Through our Improvement Academy, we are supporting front-line teams in acute hospitals and other partner organisations in the use of improvement science and evidence based interventions including safety huddles to reduce patient falls.
Building on the success of our falls reduction work to date, (which has seen up to 50% reduction in falls on participating wards and an independently validated return on investment of over 300%) this programme improves patient outcomes and organisational efficiency through the prevention of additional costs associated with treatment and legislation resulting from inpatient falls.

Why?

There are approximately 20,000 falls per year in hospitals in the Yorkshire and Humber region. Falls contribute to patients’ loss of confidence and independence, increased distress, pain, injury, increased length of stay and, in a significant number of cases, death. Throughout the country, falls are estimated to cost the NHS more than £2.3 billion per year.

The Francis report highlighted the importance of culture when addressing the safety of patients, whilst reducing patient falls is cited as one of the ten Patient Safety areas identified in the Effectiveness Matters publication (York University, Centre for Reviews and Dissemination, 2013). Reducing inpatient falls within an organisation can also significantly help in creating the efficiency benefits required as part of The Five Year Forward View.
Several Yorkshire organisations, including community providers, have already asked for our support and nominated clinical teams and leaders to work together on reducing falls.

How are we helping?

Through our Improvement Academy we have developed a robust framework in which to undertake this safety improvement. Current evidence shows that multi-component interventions are effective in reducing falls, including tailored bedside signage, advice on footwear and toileting schedules. Our Improvement Academy team provides expertise, support and learning in areas such as team safety culture, improvement science and measuring for improvement.
We are supporting teams in the testing, implementation and measurement of interventions as follows:

  • Falls safety briefings (huddles) led by senior clinicians, to support the team to identify those patients most at risk of falling and plan to prevent such a fall
  • Above bed signage – to identify at a glance patients who are most at risk of falling
  • Reliable, pre-breakfast “intervention” for all patients – including toileting for those most at risk of falling
  • Supporting the assessment of teamwork, safety culture and measurement of impact using PDSA cycles and easy to understand visual display of data for teams.
  • Celebrating success and positive reinforcement of actions by recognising achievements.

Our Impact to date

Through our Improvement Academy, the Yorkshire & Humber AHSN is working with 20 frontline teams across the region. We have been successfully reducing the number of falls and time between falls and capturing the progress along the way.

  • A pilot project in 2014/5 supporting front-line teams in Leeds Teaching Hospitals to reduce falls was positively evaluated, showing 50% reductions in falls in engaged ward teams.
  • A 2014 Health Economics Evaluation was conducted on safety huddle intervention provided by the Improvement Academy and the savings were calculated at £185,690, providing an ROI of 388%. (Sensitivity analyses indicate the expected ROI is robust to changes in event rates, costs and savings).
  • A group of four wards has reduced the combined average number of falls per week by 60%
  • One ward has moved from an average of one fall per week to repeatedly achieving 30 days between fall and up to 60 days.
  • Click here to see our impact extracted from our 2016 annual report.

Next Steps

  • Our Improvement Academy is working in partnership with Leeds Teaching Hospitals NHS Trust to be part of the Health Foundation Scaling Up Improvement Programme. This will run for 2.5 years and has received funding to support the implementation and evaluation of the programme.
  • Throughout 2016/17 we will continue to offer this programme to all members, targeting acute trusts in the region but extending support into community services and GP surgeries. We aim to embed the safety huddles initiative into 150 ward teams across the region, spreading the initiative to focus on other areas of patient harm including; deteriorating patients and sepsis.
  • Quality Improvement training is available to actively encourage improvement across all member organisations.
  • Work on scaling up beyond the Yorkshire & Humber region has started. The Improvement Academy is engaged with Kent, Surrey and Sussex AHSNs as part of a training programme demonstrating the impact of the safety huddle and patient safety culture.

Click here for more information on the Improvement Academy’s work in this area.