Hourly Rounding – A Falls Prevention Change Initiative

Deer Lodge CentreWinnipeg, MB

A 431 Long Term Care Facility providing personal care, chronic/extended care, rehabilitation & assessment services

for all, including veterans.

Tracy Thiele, Project CoordinatorCarol Anderson, Clinical Educator

Issue

Although our falls statistics have steadily declined, a trial of hourly rounding was initiated to continually evolve our Falls Prevention and Management Program. The trial did not yield the anticipated results and the program was not sustainable.

2042

2193 2145

1923

16961576

0

500

1000

1500

2000

2500

To

tal F

alls

2005 2006 2007 2008 2009 2010

Year

Total Falls per Year PCH, Chronic Care, and A&R

Data Source: Occurrence Reporting SystemData Excludes: Near Misses

Aim: To secure a solidly established base of understanding and a consistent approach regarding the benefits of hourly rounding

Falls is the leading cause of injury-related death and hospitalization for older adults in Manitoba and accounts for 54% of all regional critical incidents.

Interventions The development of a interdisciplinary working group to re-

exam initiating and sustaining hourly rounding

New trials took place on a rehabilitation and personal care unit

Identified factors known to facilitate or act as barriers to sustainability (e.g. attitudes & relevance of the issue)

Changed the method of conducting hourly rounding by implementing policy and documentation sheet

Created an action plan for sustainability, including; steps to be taken to achieve aim, timeframe, person responsible, and what was monitored to identify achievement

• Start slow and work out the “kinks" before trying to expand

• Remember it takes time to change practice. Do not expect immediate results

• Conduct ongoing audits regularly and address issues and concerns as they arise

• To get staff buy-in requires them to feel involved in the process

• Provide positive feedback and support in many different ways

• To engage staff early, be creative in advertising and roll out

Lessons Learned

With the quality time spent on our trials we are successful in preventing falls and have developed an excitement and anticipated for the centre wide roll out

The falls prevention change initiative focuses on improving quality care in patient safety, patient and staff satisfaction, and change management