Quality Improvement Program: Fall Prevention in Long-Term Care

Source: https://dsc.duq.edu/cgi/viewcontent.cgi?article=1014&context=dnp

This program focuses on reducing falls among residents in a long-term care facility.

Structures:

• Quality Improvement Team: A multidisciplinary team consisting of nurses, therapists, social workers, and facility administrators.
• Data Collection Tools: Fall incident reporting forms, resident assessment tools, environmental checklists.
• Policies and Procedures: Fall prevention protocols, resident care plans, medication management guidelines.

Processes:

1. Identification: Reviewing fall incident reports to identify trends and risk factors for falls.
2. Assessment: Conducting resident assessments to identify individual fall risks and contributing factors (e.g., gait problems, medications, environmental hazards).
3. Intervention: Implementing individualized fall prevention strategies based on resident assessments, such as:
   • Modifying the resident’s environment (e.g., removing clutter, installing grab bars).
   • Providing assistive devices (e.g., walkers, canes).
   • Implementing exercise programs to improve strength and balance.
   • Reviewing medications that might increase fall risk.
4. Monitoring and Evaluation: Regularly monitoring residents’ progress, tracking fall rates, and adjusting interventions as needed.
5. Feedback and Improvement: Reviewing program effectiveness through data analysis, team meetings, and resident feedback, and continuously improving the program based on findings.

Outcomes:

• Reduced fall rates among residents.
• Improved resident mobility and independence.
• Increased staff awareness of fall prevention strategies.
• Improved collaboration and communication among disciplines.

Regulatory Minimum Standards:

• Federal Nursing Home Regulations (F-Tags): These regulations mandate that long-term care facilities have a comprehensive resident assessment process and implement individualized care plans to address identified needs, including fall prevention.

Deming’s Process Improvement Cycle:

This program aligns well with Deming’s Process Improvement Cycle (Plan, Do, Check, Act).

• Plan: The program establishes a team, identifies goals, and develops fall prevention strategies.
• Do: The team implements the interventions for residents at risk of falling.
• Check: Fall rates and resident assessments are continuously monitored to evaluate effectiveness.
• Act: Based on data and feedback, the team refines interventions, modifies the program, and continues to improve fall prevention strategies.

Therefore, this quality improvement program demonstrates a cyclical approach to fall prevention, aligning with Deming’s philosophy of continuous improvement.

Rationale:

The program actively seeks feedback and uses data to modify and improve interventions, adhering to the core principles of Deming’s cycle:

• Focus on the customer (residents): The program prioritizes resident safety and well-being by addressing their individual fall risks.
• Empowerment: The multidisciplinary team collaboratively identifies and implements solutions.
• Data-driven decision making: Fall rates and resident assessments guide adjustments to the program.
• Continuous improvement: The cycle ensures continuous evaluation and refinement for better fall prevention outcomes.

Overall, this quality improvement program exemplifies a structured approach to fall prevention, aligned with Deming’s Process Improvement Cycle, aiming to enhance resident safety and well-being in a long-term care facility.