19 Integrated Falls Prevention Pathways; the Benefits of Organisational Collaboration

Abstract

Introduction There is continuous increased demand on the NHS, whileresources are finite. Developing pathways with Integration and streamlining of services is crucial to achieve good outcome and better use of resources. Falls service is a good example. In Dudley,three separate services existed for managing falls: a localauthority team, a NHS therapy team and a Consultant-led Falls &Syncope clinic. We collaborated and reorganised the services toimprove patient care and achieve better outcome. Methods We integrated services into one pathway, where patients aretriaged to the relevant service based on clinical need via a SinglePoint of Access. One multifactorial assessment-based on NICEguideline CG161 and Quality Standard QS86-was developed, whichis completed by all services (streams). This allows theirassessment to be transferred to another stream if clinicallyindicated, saving repetition/duplication. An extensive trainingprogramme was delivered to up-skill staff across the pathway incompleting areas of best practice (e.g. postural BP measurement,balance/mobility assessments, cognitive assessment, FRAX score,medication issues). Additionally we established a Falls MDTmeeting with representation from all streams, to discuss complexcases, and developed a shared, electronic database to track patientjourneys and monitor service outcomes. Results Falls admission rate decreased by 29.4% for patients 65 y and overand 25.2% for 80+. This equates to 433 fewer falls compared to peak rate; saving an estimated £3.4million. Also, hip fractureadmission rate decreased by 19.2% for patients 65 y and over and23.5% for 80+. This equates to 91 fewer hip fractures compared topeak rate; saving an estimated £1.3million. Much improved servicecollaboration and resource sharing. Conclusion A collaborative approach between organisations, utilising existingresources in a system that places patients at the heart of theservice, improves patient experience and outcomes, alongsidesignificant financial savings.