How to Prevent Falls and Fall-Related Injuries: A Virtual Breakthrough Series Collaborative in Long Term Care

摘要

Aims: To reduce preventable falls and fall related injuries in State Veterans Homes (SVHs), we conducted a virtual breakthrough series (VBTS) quality improvement collaborative. Methods: Participating teams attended educational calls, received coaching, and submitted reports on process changes. Outcomes for the project included fall rates (total number of falls divided by the total number of census days reported) and fall injury rates (total number of falls with any injury divided by the total number of census days reported). Outcomes were tracked 6 months before, during, and after the project and compared using a Poisson regression model. Results: Twenty-six SVHs participated and implemented 27 unique interventions. The most commonly implemented interventions included post fall huddles, staff education, and intentional rounding. There was significant improvement in the fall related injury rate (injuries per 100 census days), decreasing from 7.4 before, to 6.6 during (p = 0.009) and 5.6 after (p = 0.005) the VBTS. The minor injury rate (minor injuries per 100 census days) decreased significantly from 6.4 during the VBTS to 5.8 (p = 0.000) after the VBTS. There was no statistically significant decrease in total fall rates or major injury rates. Conclusion: Lessons learned may be of interest to other SVH facilities seeking to improve their falls prevention program.