Authors (including presenting author) :
Chan ACM(1), Chau RMW(2), Poon MWY(3), Chao CYL(1)
Affiliation :
(1)Physiotherapy Department, Queen Elizabeth Hospital, (2) Physiotherapy Departmen, Kowloon Hospital, (3) Physiotherapy Department, Hong Kong Buddhist Hospital
Introduction :
Falls prevention remains to be a considerable challenge across the care continuum in healthcare settings and community. It is one the most frequently reported patient incident in the Advanced Incidents Reporting System (AIRS). According to the statistics of COC-Grade (Physiotherapy), the overall patient falling is approaching 45% of all types of reported patient incidents by physiotherapy in Hospital Authority. Therefore, “patient falls” remains to be an important identified “Risk Register” in the physiotherapy department of KCC. Factors causing patient falls are multi-factorial. Successful interventions and sustainable fall rate reduction relied on accurate risk factors identification and effective multicomponent preventive strategies.
Objectives :
The “Safety Optimization Program” of the Physiotherapy Department of the Kowloon Central Cluster in enhancing falls awareness & prevention, can be dated back to 2003 upon clustering. With concerted effort from QEH, KH & BH, the program brought about drastic decrease in fall incident from 0.052 to 0.026 per 1,000 attendances right after. Sessions of Zero Fall incidents were maintained. The objectives of the program are to:
(i) uplift standard of patient safety in fall prevention adopting multifactorial analysis and interventional approach
(ii) minimize fall incidence
(iii) enhance the sustainability of all the intervention measures
(iv) deepen safety culture in all rank of staff
Methodology :
The “Safety Optimization Program” included multicomponent quality & safety improvement initiatives in domains of (i) Patient factors: early detection & flagging of at-risk patients for individualized interventions, prescription of mobility aids, contextual caregivers training & home safety recommendations
(ii) Staff factors: on-going staff training & boost dose review such as fall risk screening for professional staff, manual handling operation & use of safety belt training for supporting staff, learning points sharing of all fall incidents of HA PT departments (iii) Equipment/machine factors: enhanced safety & monitoring for physiotherapy equipment (e.g. structured inspection & audit check for walking aids), safety awareness signage, use of fall prevention gadgets (iv) Environmental factors: Environmental Ambassadors (professional & supporting) in each designated clinical areas for ensuring all pieces of equipment & facilitates in the venue concerned are in neat & safe conditions.
Result & Outcome :
The patient fall incident rate remained at a very low level (<0.03 per 1,000 patient attendances) in PT departments of KCC, ranking the lowest among all the clusters in HA. There was nil patient fall incident or staff IOD incident related to environmental hazard. Early identification with timely intervention & education was given to the patients & caregivers for the at risk groups. All the walking aids & physiotherapy equipment / machines were inspected in systematic & organized ways for enhancing safety and efficiency. A comprehensive fall prevention program should be multi-components. The present Safety Optimization Program provides a holistic systematic model for enhancing safety of all occupants in the PT department. It also promoted ownership & engagement of professional and supporting staff to strive for continuous improvement for providing a safety working environment. The new KCC family will harvest another opportunity of synergy for excelling the current achievement.
Co-location with:
