Using a collaborative approach to reduce falls in older people’s adult mental health wards in a local health board in Wales

Between April 2020 and March 2021, the number of fall-related emergency admissions in England for adults over 65 years was 1933 per 100 000 people. Adult patients in hospital may be at risk of falling for many reasons including a history of falls, being medically unwell, dementia or delirium, the ef...

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Main Authors: Melanie Davies, Simon Williams, Louise Walker, Dolores Macchiavello, Zoe Williams, Paul Gimson, Kerstin Ackermann-Lloyd, Sophie Bassett, Christopher Bevan, Anna Brooks, Naomi Elias, Jessica Gapper, Gemma Gash, Andrew Hermolle, Naomi Hill, Caroline Humphreys, Bhuvan Kckhadka, Ana Llewellyn, Bleddyn Marsh, Leah Price, Bethan Rees, Leah Richards, Alison Sproston, Eleri Wright, Philippa Clark
Format: Article
Language:English
Published: BMJ Publishing Group 2025-04-01
Series:BMJ Open Quality
Online Access:https://bmjopenquality.bmj.com/content/14/2/e003219.full
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author Melanie Davies
Simon Williams
Louise Walker
Dolores Macchiavello
Zoe Williams
Paul Gimson
Kerstin Ackermann-Lloyd
Sophie Bassett
Christopher Bevan
Anna Brooks
Naomi Elias
Jessica Gapper
Gemma Gash
Andrew Hermolle
Naomi Hill
Caroline Humphreys
Bhuvan Kckhadka
Ana Llewellyn
Bleddyn Marsh
Leah Price
Bethan Rees
Leah Richards
Alison Sproston
Eleri Wright
Philippa Clark
author_facet Melanie Davies
Simon Williams
Louise Walker
Dolores Macchiavello
Zoe Williams
Paul Gimson
Kerstin Ackermann-Lloyd
Sophie Bassett
Christopher Bevan
Anna Brooks
Naomi Elias
Jessica Gapper
Gemma Gash
Andrew Hermolle
Naomi Hill
Caroline Humphreys
Bhuvan Kckhadka
Ana Llewellyn
Bleddyn Marsh
Leah Price
Bethan Rees
Leah Richards
Alison Sproston
Eleri Wright
Philippa Clark
author_sort Melanie Davies
collection DOAJ
description Between April 2020 and March 2021, the number of fall-related emergency admissions in England for adults over 65 years was 1933 per 100 000 people. Adult patients in hospital may be at risk of falling for many reasons including a history of falls, being medically unwell, dementia or delirium, the effects of their treatment or medication, poor mobility, visual and other sensory impairments along with their general well-being. Research has shown that falls can be reduced by 20%–30% through multifactorial assessments and interventions. The aim of these assessments and interventions is to identify and treat underlying reasons for falls such as muscle weakness, cardiovascular problems, dementia, delirium, incontinence and medication. However, national audits have found low levels of implementation of these assessments and interventions in UK hospitals. As part of a new patient safety improvement initiative, a collaborative was developed to reduce the incidence of in-patient falls rate per 1000 bed days within five older adults’ mental health wards in a health board in Wales. The falls collaborative project has resulted in substantial improvements in care, including an increase of patients receiving lying and standing blood pressure assessment, medication review and delirium assessments. While reported falls rates stayed the same for the five wards, when each ward individually was factored in, we saw a reduction in two wards and estimated that the increase in falls for the remaining of three wards was related to a previous state of under-reporting, considering the numbers stayed levelled throughout the collaborative. The small reduction we saw was achieved without any extra support or allocated resources, and the ongoing staffing challenges all five wards experienced throughout the collaborative, all these improvements were received as a great success. The team was shortlisted for the National Health Service Wales Awards in the Safe Care category, something they took great pride in.
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spelling doaj-art-99cf9267adaa4ed3b4e3b06ad7a6b3a12025-08-20T03:09:55ZengBMJ Publishing GroupBMJ Open Quality2399-66412025-04-0114210.1136/bmjoq-2024-003219Using a collaborative approach to reduce falls in older people’s adult mental health wards in a local health board in WalesMelanie Davies0Simon Williams1Louise Walker2Dolores Macchiavello3Zoe Williams4Paul Gimson5Kerstin Ackermann-Lloyd6Sophie Bassett7Christopher Bevan8Anna Brooks9Naomi Elias10Jessica Gapper11Gemma Gash12Andrew Hermolle13Naomi Hill14Caroline Humphreys15Bhuvan Kckhadka16Ana Llewellyn17Bleddyn Marsh18Leah Price19Bethan Rees20Leah Richards21Alison Sproston22Eleri Wright23Philippa Clark24Cwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKImprovement CTM, Cwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKImprovement CTM, Cwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKCwm Taf Morgannwg University Health Board, Abercynon, UKBetween April 2020 and March 2021, the number of fall-related emergency admissions in England for adults over 65 years was 1933 per 100 000 people. Adult patients in hospital may be at risk of falling for many reasons including a history of falls, being medically unwell, dementia or delirium, the effects of their treatment or medication, poor mobility, visual and other sensory impairments along with their general well-being. Research has shown that falls can be reduced by 20%–30% through multifactorial assessments and interventions. The aim of these assessments and interventions is to identify and treat underlying reasons for falls such as muscle weakness, cardiovascular problems, dementia, delirium, incontinence and medication. However, national audits have found low levels of implementation of these assessments and interventions in UK hospitals. As part of a new patient safety improvement initiative, a collaborative was developed to reduce the incidence of in-patient falls rate per 1000 bed days within five older adults’ mental health wards in a health board in Wales. The falls collaborative project has resulted in substantial improvements in care, including an increase of patients receiving lying and standing blood pressure assessment, medication review and delirium assessments. While reported falls rates stayed the same for the five wards, when each ward individually was factored in, we saw a reduction in two wards and estimated that the increase in falls for the remaining of three wards was related to a previous state of under-reporting, considering the numbers stayed levelled throughout the collaborative. The small reduction we saw was achieved without any extra support or allocated resources, and the ongoing staffing challenges all five wards experienced throughout the collaborative, all these improvements were received as a great success. The team was shortlisted for the National Health Service Wales Awards in the Safe Care category, something they took great pride in.https://bmjopenquality.bmj.com/content/14/2/e003219.full
spellingShingle Melanie Davies
Simon Williams
Louise Walker
Dolores Macchiavello
Zoe Williams
Paul Gimson
Kerstin Ackermann-Lloyd
Sophie Bassett
Christopher Bevan
Anna Brooks
Naomi Elias
Jessica Gapper
Gemma Gash
Andrew Hermolle
Naomi Hill
Caroline Humphreys
Bhuvan Kckhadka
Ana Llewellyn
Bleddyn Marsh
Leah Price
Bethan Rees
Leah Richards
Alison Sproston
Eleri Wright
Philippa Clark
Using a collaborative approach to reduce falls in older people’s adult mental health wards in a local health board in Wales
BMJ Open Quality
title Using a collaborative approach to reduce falls in older people’s adult mental health wards in a local health board in Wales
title_full Using a collaborative approach to reduce falls in older people’s adult mental health wards in a local health board in Wales
title_fullStr Using a collaborative approach to reduce falls in older people’s adult mental health wards in a local health board in Wales
title_full_unstemmed Using a collaborative approach to reduce falls in older people’s adult mental health wards in a local health board in Wales
title_short Using a collaborative approach to reduce falls in older people’s adult mental health wards in a local health board in Wales
title_sort using a collaborative approach to reduce falls in older people s adult mental health wards in a local health board in wales
url https://bmjopenquality.bmj.com/content/14/2/e003219.full
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