News and updates from today's Falls conference
Following the chairs introductions, Dr Zuzanna Sawicka Consultant Geriatrician Mid Yorkshire Hospitals NHS Foundation Trust & Clinical Lead, Future Development Site Royal College of Physicians, London, opens the conference with a session on 'Changing care systems for people with frailty' covering:
• ensuring all clinicians acquire the knowledge and skills appropriate for safe and competent
care of older people with comorbidities and frailty
• improving integration and joined up working
Dr Sawicka's Presentation abstract:
Over recent years, there has been a change in way medicine for older people is managed and the issue of frailty is now seen as the most problematic expression of ageing. Frailty is a state of vulnerability where loss of physiological reserve makes a person susceptible to disability from minor stresses. This is usually a consequence of cumulative decline and affects the outcome for patients. This has shifted care from the management of older people to a more holistic view of the management of those with frailty.
Mid Yorkshire NHS Trust has three hospital sites, and is in the process of reconfiguring most of its acute services onto one site at Pinderfields Hospital, Wakefield. This together with national guidelines and the rapid increase in the number of frail and older patients within the local community, have led to the creation of the Rapid Elderly Assessment Care Team (REACT) and two dedicated Acute Care of the Elderly Units. The implementation and redesign of services was one of the development sites for the Royal College of Physicians, Future Hospital Programme and forms part of the Wakefield approach to the management of frailty.
The Rapid Elderly Assessment Care Team is designed to facilitate much earlier hospital discharge for older people living in Mid Yorkshire area with acute illnesses and exacerbations of chronic conditions and is now concentrated on dedicated acute admission designed with the elderly in mind This means that comprehensive geriatric assessment starts early and plans can be made earlier especially as evidence suggests 46% of those over the age of 85 who are admitted to hospital will be dead within the following year. The team shortens admission periods and facilitates more “timely” discharge, thus reducing family stress and disruption and the economic impact of hospitalisation.
These changes in the way we manage the care of older people and those with frailty, have led to improvements in patient care through co-production with patients. The team also benefit from collaborative working and leadership improving staff engagement and leading to further innovative practice directed at enhancing patient’s experiences.
Continuing is Helen McGahon Head of Physiotherapy and Falls Champion North Cumbria University Hospitals, with a session on 'Learning from a Falls Collaborative Case Study', and discusses:
• identifying and grouping interventions that lead to successful outcomes
• Quality Improvement methodology
• linking with #endPJparalysis – getting patients moving
• our experience in North Cumbria
Helen's biography: Helen included the role as Falls Champion for North Cumbria University Hospitals Trust to her portfolio in late 2016. The Trust had poor inpatient falls performance with high levels of harm. Helen developed a strategy to raise the profile of improvements to reduce inpatient falls. To ensure all staff groups accepted the shared responsibility to reduce falls the strategy included establishing a Trust Falls Steering Group. The steering group includes executive representation, Specialist Elderly Care Doctor, Nurse, AHP and Pharmacy staff who have the capacity to influence change.
Helen successfully secured a place on NHS Improvements 90 day Falls Collaborative in 2017 to gain support with improvement in reducing falls in two ward areas challenged with high fall rates. She used the improvement methodology to engage other wards to support a Trust wide improvement.
ALSO OF INTEREST:
Falls Prevention Summit 2018: Reducing Inpatient Falls & Harm from Inpatient Falls
Wednesday 23 May
The Studio Conference Centre
A Practical Guide to implementing New National NICE Quality Standard for Parkinson’s Disease
Friday 16 March
De Vere W1 Conference Centre
Improving End of Life for People with Dementia
Friday 15 June
De Vere West One Conference Centre
2 March 2018