Fall Prevention in General Out-patient Clinics / Hong Kong East Cluster

Abstract Description

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Authors (including presenting author) :

Chow WPA, Cheung YHK, Cheung PH, Cheung HT, Kwan WFM, Lam HW, Kwan WYW, Wong MSM, Wong MYM

Affiliation :

Department of Family Medicine and Primary Health Care, Hong Kong East Cluster, Hong Kong

Introduction :

Patient fall is a common risk factor that may lead to injury and hospitalization. The incidence of out-patient fall may cause severe complications such as fractures that require surgeries and large socioeconomic costs to the patients and families. In 2016, the GOPC of Hong Kong East Cluster (HKEC) has formed a workgroup with multidisciplinary team of medical, nursing, physiotherapist and occupational therapists staff to review the fall incidents of outpatients, identify root causes of fall injury and work out a number of measures to prevent fall injury in clinics.

Objectives :

1.To reduce the fall incidents in GOPCs and minimize patient injuries related to fall 2.To co-ordinate with Allied Health staff to follow up fall cases at Fall Clinic 3.To ensure a safe environment and early detection of potential hazards 4.To recommend strategies for continuous improvement on fall prevention in GOPCs 5.To enhance staff awareness on fall prevention

Methodology :

Fall incidents reports were reviewed to analyze the age, sex, location, severity index and contributory factors of fall. A Fall Assessment Checklist was designed for doctors and nurses to assess the patients and rule out the contributory factors of fall injury. Photos were also taken for case review.

Result & Outcome :

The fall incidents of 2016 to 2018 were reviewed in regular meetings. A number of improvement measures were implemented such as referral of patients to Fall Clinic, site inspection to recommend on furniture layout and patient flow, signage and floor guide review, supporting staff training and provision of extra assistance to patients with high fall risks. The number of fall incidents showed a decreasing trend of 11 % in 2017 and further decrease of 20 % in 2018. The severity index, according to AIRS 3.0 definition, has shown decrease from a range of 1 to 4 in 2016 to a range of 1 to 2 in 2017 and 2018. Two cases of significant morbidity were reported in 2016 and only minor injury was reported in 2017 and 2018. In comparing the three years data of fall incidents, a major improvement was shown in fall prevention and management of fall patients in out-patient clinics.