Implementing Interdisciplinary Communication to Decrease Falls in a Post-Acute Care Setting: A Quality Improvement Initiative

Abstract

Falls are the leading cause of accidental deaths in older adults, and are a growing public health concern. People aged 65 and older are at increased risk for falls and account for 20-30% of mild to severe injuries and more than 50% of injury-related hospitalizations. Studies have shown that evidence-based interventions to improve communication and implement team based approaches to care results in improved outcomes. The purpose of this quality improvement project was to educate all staff in a long-term care rehabilitation facility on fall prevention, implement a falls huddle, SBAR (situation, background, assessment, recommendation) communication methods to promote compliance with the program by improving communication, and decreasing in number of falls. The pre-project data collection involved reviewing the current falls policy, screening measures, and a retrospective review of data related to facility falls, including type of injury sustained related to fall. Interventions to improve communication included a brief (5-10 minute) interdisciplinary huddle at the shift change to identify residents at risk for falls as well as a post-fall huddle tool to address acute falls. The staff communication approach utilized the SBAR technique. A post fall huddle took place within 30 minutes following a fall and included all members of the health care team involved, the patient, and family member, if present. Data collection took place at 30, 45, and 60 days after implementation, to follow up on the quality improvement, assess number of falls, and determine if the intervention yielded an improvement in the fall rate. After staff education and implementation of the project tools, data review did not show significant changes in the overall number of falls. Utilization of the post-fall huddle reporting tool was nil. A falls committee was started during the course of the project and continues. Facility leadership reports increased knowledge and communication regarding falls continues to improve.