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Holy Family Hospital Site Leader Rae Johnson and her team have come up with a deceptively simple plan to reduce the rate of falls among elderly residents and already their volunteer-driven program is seeing results.

A fall prevention program at Holy Family Hospital may be the first of its kind in the world

December 12th, 2017
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New “Fallunteers” program showing 40% reduction in falls among residents

Holy Family Hospital may be 70 years old this year—but the ideas coming from within its walls are fresh and new.

For example, Holy Family Site Leader Rae Johnson and her team are currently working on a project that began, a couple of years ago, as a deceptively simple idea for fall prevention: use volunteers to keep an extra eye on residents during times that had been identified as high frequency for falls.

Data showed that residents were falling at a higher frequency between 4PM-8PM, which made sense given it’s a time of day when 1) residents are getting tired; 2) there are fewer activities to keep them occupied; and 3) less staff are on duty.

But “Fallunteers,” which the program is named, is also one of those ideas that is so simple it makes you wonder: has someone else already thought of this?

“When we came up with the idea, we reviewed the medical literature, looking for fall prevention programs both here and in other countries that used volunteer monitors, and we couldn’t find anything,” says Rae. “When we did find something volunteer-related, the volunteers were engaging with staff, not the residents. So ours may be the first program of its kind, which would be very exciting.”

There is beauty in simplicity

The more you learn of the program, the simpler it becomes. Volunteers, for example, are not expected to be caregivers, nor are they expected to have any medical training. Instead, they are meant to be just “another set of eyes” to watch residents.

“We want anyone to be able to volunteer,” says Rae. “That’s part of the spirit of the program. All you need is to be able to give your time, and you will be helping residents. There is no special training required.”

It is as simple as this: If you, the volunteer, see a resident straining to reach for something on a shelf, walk over and ask if you can get it for them. That’s a potential fall avoided. For when we consider issues such as age, physical disability, dementia—suddenly just reaching for something can be hazardous.

In health care, where budgets are finite and resourcefulness is a must, Fallunteers scores high marks as programs go: first, it’s working (falls at Holy Family have already been reduced by 40% in areas where a program volunteer is present); second, it was able to be implemented almost immediately; and finally, it costs—practically nothing.

New and innovative thinking

The PHC elder care team, which cares for 721 residents across six residential care sites, seems to be highly adept at coming up with innovative ideas that are effective, affordable and, in many cases, able to be implemented quickly.

Much of this new wave of thinking stems from the larger Residential Care for Me project that has seen PHC assume a leadership role in elder care in both BC and Canada thanks to innovative leaders like Elder Care and Palliative Services Program Director Jo-Ann Tait, who studied elder care models in Europe and brought components of what she learned there to PHC.

Add Rae Johnson and her team at Holy Family to this list of original thinkers.

Falls are triggers to health care

“Of course, there are lots of fall prevention programs in hospitals and residential care homes around the world,” says Rae, “because falls are a common trigger for health care and, in older adults, for ongoing care. For an older person, a serious fall can be the event that prompts a move from living at home to moving into residential care.”

Rae says they want to prevent falls at Holy Family but they don’t want to prevent them in ways that would increase the use of restraints.

“We do not have people restrained,” says Rae. “It’s better for residents to continue to walk, to continue to be mobile, as this helps them to be less likely to fall. But even when they have good mobility, they are still at risk.”

The best fall prevention strategy for older adults, and especially for those with dementia, is increased supervision. However, increased supervision means increased staff, which is not always possible. This makes a volunteer-driven program like Fallunteers that much more resonant.

Beginnings

Holy Family had long been looking at ways to prevent and reduce falls.

“We were doing everything we could,” says Rae. “We had low beds, we had fall mats, we had hip protectors, we had bed alarms, chair alarms—but we were still having falls. And really, we always will. But we kept working on ways to reduce their occurrence and to reduce injury from falls.”

The Fallunteers idea assumed its first official form thanks to a PHC program called the Research Challenge, which is an annual competition open to all PHC point-of-care staff.

“We received $5,000 through the Research Challenge competition,” says Rae, “and that enabled us to free up some staff time to devote to Fallunteers in terms of analyzing data and writing proposals.”

The Research Challenge also connected Rae to the Centre for Health Evaluation and Outcome Sciences at St. Paul’s (CHÉOS), a team of researchers and health professionals who helped Rae and her team develop their approach to research with an aim of being able to better collect, measure and analyze their findings.

“We were able to go to CHÉOS and say, ‘This is how we think we’ll do it,’” says Rae, “and they would say, ‘Well, if you want to try and prove anything, you should try it like this.’ So they helped us arrive at the best methodology. Then we gather all our data, they crunch it and come up with these outcomes and let us know which ones are significant. So the Research Challenge and CHÉOS were both a huge plus for us.”

But is Fallunteers a first-in-world achievement?

We’ll find out as the program moves through various required channels.

Rae has already presented the program within Providence Health Care and is also meeting about submitting it to Accreditation Canada as a leading practice. The next step after that will be to publish Fallunteers as an academic paper for peer review.

For the team at Holy Family, this is an exciting time—not to mention a great way to celebrate the hospital’s 70th birthday!

And to celebrate the beauty of simplicity, too…

“Yes,” says Rae, “it’s a simple concept, and to everyone we explain the Fallunteers program to, the reply we get is always the same—‘Why didn’t I think of that!’”

St. Paul’s Foundation is a proud supporter of elder care across Providence Health Care. To support PHC residential care programs—and to help make innovative programs like Fallunteers a reality—give to St. Paul’s Foundation now.

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Want to read more about the innovative work in elder care at Providence Health Care?

Volunteer residents provide spiritual support for their neighbours

The role of music, humour and human touch in residential care

The tale of the iron (and other learnings in residential care)

“I don’t call it elder care, I call it living”

 

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