The second stage of the Improving Care for Older People (ICOP) program operated in Victoria from 2010 to 2013. Across Victoria, 35 public health services participated in the initiative, including all metropolitan health services. As part of the program, they were required to undertake initiatives to minimise the risk of functional decline in older patients and improve the provision of care in four areas:
- Evidence-based environmental improvements
- Organisation-wide policy development that provides a framework for improving care for older people across the organisation
- Embedding the evidence base contained within The Toolkit to inform models of care to minimise functional decline for older people, with a focus on acute settings
- Professional development activities to support workforce capacity building to better respond to the needs of older people in hospital settings
Outlined is a snapshot of the types of initiatives taken by health services relating to mobility and falls prevention.
Health Service | Requirement Addressed and Project Summary |
Albury Wodonga Health | Models of Care - Functional Maintenance Program implemented in acute wards at Wodonga – to be rolled out to Albury Campus; bed based exercise program via patient television operating in Albury – will roll out to Wodonga Models of Care - Falls committee meets monthly; introduction of hip protectors to acute wards; possible future introduction of ‘stick to stand’ system and gripper socks |
Austin Health | Policy Development - Falls Risk Policy; Falls Risk Assessment Prevention and Management Guideline; Nurse Rounding Guideline (awaiting final approval) and Functional Maintenance Guideline and Policy (awaiting final approval) Models of Care – Focus on nurse rounding – was rolled out across 20 wards on three hospital campuses, and one residential aged care (RAC) facility. There was a significant reduction in falls Professional Development - Rounding education incorporated into hospital orientation, graduate nurse orientation, night duty study days and ward in-services |
Bairnsdale Regional Health Service | Policy Development - Functional Maintenance Policy developed Models of Care - Falls, infection, medication, pressure (FIMP) group established – uses unit based nursing ‘champions’ for each standard – receive education and responsible for sharing; developed resource folders including Toolkit information as well as instructions for intranet access of Toolkit Professional Development - Staff member trained as Functional Independence Measure (FIM) trainer; 31 staff trained as FIM assessors |
Ballarat Health Services | (at Nov 2012) Models of Care – 6-PACK falls prevention project – research project/intervention pilot for high falls risk patients conducted by Monash University at six hospitals around Australia |
Barwon Health | Policy Development - Falls Prevention Policy implemented incorporating Improving Care for Older Persons (IC4OP) principles Models of Care – Falls Risk Assessment Tool (FRAT) included in e-risk assessments - Falls awareness campaign – includes film on free TV channel; poster displays, articles in local media and social media - Nurse rounding implemented in Rehabilitation Centre wards, palliative care wards and some acute wards Professional Development - Education sessions around falls risk and management including the use of FRAT |
Bass Coast Regional Health | Environmental Improvements - Patient activity area created in medical ward Policy Development - Review of falls policies; brochures developed; use of Upright and Independent Program Professional Development - Eight staff trained as FIM assessors |
Bendigo Health | Policy Development - Redeveloped policies including Falls Assessment and Management Models of Care - ICOP mobility project officer; development of falls resource section on Intranet; introduction of red socks in clinical areas |
Castlemaine Health | Models of Care - Introduction of Falls Risk Assessment and Management Tool (FRMT), identifiers for high falls risk patients (orange dots on patient board and above bed), falls incident stickers; introduction of Functional Maintenance Program (exercise program) (continuing); introduction and ongoing use of red (grip) socks; electronic falls resource folder created; annual April Falls Day established for awareness/education Professional Development - Falls education provided as annual competency |
Colac Area Health | Policy Development - Falls Prevention and Management for Older Acute Patients policy Models of Care - Falls prevention focus including use of ‘red socks’ for high risk patients and introduction of non-slip mats in acute ward; easy identification of high risk patients via coloured medical record folders; five step intervention posters for staff in residential aged care and acute wards; FRAT e-training mandatory for all staff; brochures for patients/families introduced; assessment forms include person centred care; Falls Committee meets regularly (ongoing) and input to other areas including Quality and Research Committee - Acute ward - individualised functional arrangement in patient’s room to align with needs, reduce risks and create more ‘home like’ setting - Introduction of nurse rounding – gradual roll out across organisation – currently in RAC and acute |
East Grampians Health Service | Environmental Improvements – Introduction of ‘red dot’ notification boards (falls risk/mobility) Policy Development - ICOP principles embedded in policies including Preventing Falls and Harm from Falls Models of Care - FRAT completed on admission for all older people; bedside audits for Falls risk completed; Falls Minimisation and RED Dot system brochures developed and distributed; Red Dot system to denote falls risk in place; use of referrals and equipment for high falls risk patients |
Eastern Health | Models of Care – Falls prevention initiative; volunteer delivered falls prevention interventions- supported by Gerontology Clinical Nurse Consultant (CNC) and Personal Care Assistant (PCA) who oversee and work with volunteers |
Echuca Regional Health | Models of Care - falls and balance clinic established – focus on high risk, both inpatients and outpatients |
Goulburn Valley Health | Environmental Improvements - falls prevention – stick to stand trial, improved flooring Policy Development - Clinical Practice Guidelines with ICOP focus developed and introduced including falls prevention Models of Care - Policy work on preventing falls and harm from falls including reporting and monitoring systems, staff training, use of ‘rounding’ |
Latrobe Regional Hospital | Policy Development - ICOP principles embedded into policies across organisation including inpatient falls prevention and management policy Models of Care - Improved delivery of falls prevention across health service - Inpatient Falls Risk Assessment Tool (FRAT) form and Community FRAT developed, trialled and in use; patient identifier signs in use across service; continued monthly auditing of falls and alert processes, spot auditing and ongoing staff education carried out |
Maryborough District Health Service | Policy Development - Falls Assessment and Management Policy and Post Fall Management Policy under review Models of Care - Inpatient activity group weekdays focusing on strength and cognitive function – exercise physiologist, Allied Health Assistants and other Allied Health staff; red grip socks use embedded – evaluation showed significant falls reduction; use of FRAT embedded; falls incident stickers introduced; “April No Falls Week” held to raise awareness |
Monash Health | Models of Care - Introduction of nurse rounding across four campuses as part of Patient First initiative; introduction of pre and post fall management procedure for medical staff |
Stawell Regional Health | Environmental Improvements – Introduced of falls alert signage in acute ward Policy Development - Falls Prevention policy developed (unclear if implemented); falls risk committee introduced and operating; introduction of FRAT |
Werribee Mercy | Policy Development - Clinical practice guidelines developed including Falls Prevention and Management Models of Care - Magnetic risk identifiers including falls risk implemented Professional Development – 6-PACK falls education planned |
Reviewed 12 November 2015