12 Exploring Hospital Discharge as An Opportunity for Falls Prevention Exercise Referral

Abstract

Topic: Proactive prevention is at the core of the NHS Long Term plan and falls prevention is an important public health priority. National guidance recommends that all health professionals have competence in falls assessment and prevention and advise that older adults at risk of falls are considered for strength and balance exercise. With rising numbers of older adults occupying inpatient beds, some clinicians may not have the skills to identify these opportunities to prevent falls. Previously, physiotherapy staff on a respiratory medicine ward were not delivering best practice in falls prevention. Aim: Within 3 months, to achieve a 30% increase in older adults at risk of falls, being offered exercise referral at hospital discharge. Intervention: Quality improvement methodology including stakeholder engagement and Plan-Do-Study-Act cycles were used to influence behaviour change amongst physiotherapy staff on a respiratory ward. Interventions included training and a documentation sticker. For evaluation, the weekly number of older adults at risk of falls with evidence of offer for falls prevention exercise was collected over 13 weeks and evaluated on a Statistical Process Control chart. Staff confidence scores and cohort data were also recorded and described using descriptive statistics. The NHS Improvement Sustainability Model was used to measure project sustainability. Improvement: At baseline, 0/18 (0%) older adults had an offer for fall prevention exercise. Over the intervention period, this increased to 22/37 (59.5%) and demonstrated special cause variation that was confidently assigned to the interventions. There was a 44.5% improvement in staff confidence in offering fall prevention exercise. The project scored 53.7% using the NHS sustainability model. Discussion: This project demonstrated favourable behaviour change in falls prevention practice amongst physiotherapy staff on a respiratory ward. There was variability in the improvement possibly as a result of contextual influences of staffing and seasonality. Hospital discharge is a good opportunity to assess falls risk in older adults and offer information and referral for exercise. Wider implementation may be useful to help older adults optimise health outcomes but will depend on organisational stakeholder support to improve sustainability. ABSTRACT FROM AUTHOR (Copyright of Age & Ageing is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.)