inter-lhin collaboration in fall prevention planning: beyond the … slide decks... · 2017. 4....
TRANSCRIPT
Inter-LHIN Collaboration in Fall
Prevention Planning: Beyond the
Provincial Framework
February 22, 2017
1 Poll
Here
http://rgps.on.ca/files/IntegratedProvincialFallsPreventionFrameworkToolkit_July2011.pdf
Welcome & Introduction
1 Poll
Here
Fall Prevention in Ontario
There are currently a number of leading falls
prevention interventions that have proven to
decrease the rate and impact of falls in the
elderly
Many health sectors and organizations are
implementing fall prevention interventions,
including: Local Health Integration Networks
(LHINs), their Health Service Providers (HSPs)
and Public Health Units (PHUs), some
Community Health Centres (CHCs) and others
The Reality
Some great evidence-informed interventions,
screening tools and frameworks
Fragmented system
Inconsistent approach to performance and
measurement
The Intent
A provincial and integrated fall prevention
framework
Reduction in the number and impact of falls on
seniors and the health care system
Increased quality of life for seniors
Project Working Group
An integrated, multi-sector working group co-chaired by the LHINs and Public Health convened in January 2011 to formulate the Integrated Provincial Falls Prevention Framework & Toolkit
Public Health is a key partner given its mandate and experience with respect to preventing falls across the lifespan
St. John’s Rehab Hospital
Ontario Community Support Association
EOHU/BSEO
The Four Villages Community Health
Centre
Ontario Neurotrauma Foundation
OMNI Health Care
Seniors Health Research Transfer
Network (now, Seniors Health
Knowledge Network)
Bruyère Continuing Care
Accreditation Canada
Ontario College of Family Physicians
Ontario Agency of Health Protection and
Promotion (now, Public Health Ontario)
Dr. Mark Speechley
Association of Local Public Health
Agencies
Saint Elizabeth Health Care
Ontario Medical Association Ontario
Seniors’ Secretariat
Centre for Addiction and Mental Health
Ministry of Health and Long-Term Care
Regional Geriatric Programs of Ontario
SMARTRISK (now, Parachute)
Registered Nurses’ Association of Ontario
Community Outreach Programs in
Addictions
Dr. Vicky Scott
Partners
How to Achieve
• Created an Integrated Provincial Falls Prevention Framework & Toolkit that will:
• Guide the LHINs, PHUs and HSPs in effectively preventing falls and the impact of falls
• Provide a provincial performance evaluation framework and key set of indicators to be measured consistently across the province
• Collate current leading falls prevention practices and resources
Ob
jec
tive
To improve the quality of life for Ontario seniors aged 65 years and over and lessen the burden of falls on the healthcare system by reducing the number and impact of falls on
Ontario Seniors
Inclusive Local Partnerships
Comprehensive and Evidence
Based Assessment and
Intervention
Standardized Performance Measurement
Effective Governance
Establishment of an Effective LHIN-wide Falls Prevention
Program in Each LHIN
Co
mp
on
en
ts
Ap
pro
ac
h
Establishment of an Entity Responsible for Collaboration and
Alignment at a Provincial and National Level
Inter-LHIN Coordination
and Knowledge Exchange
Alignment and Collaboration with Provincial and National
Organizations & Initiatives
Integrated Provincial Falls Prevention Framework
• Provincial funding was not available
• Exercise and fall prevention programs reform came about
• Followed by Dr. Sinha’s report, Patients First, and many other initiatives such as Age Friendly Communities etc.
• That didn’t stop a few LHINs and LHIN areas to take action and develop regional strategies on fall prevention and management
• Here are three examples in Champlain, North East LHINs and South East LHIN area…
That was then, this is now
• LHIN funded part time project support in 2012
• Steering committee and governance structure
established by early 2013.
• Survey of primary and community care in early 2013
identified:
▫ Lack of a consistent approach
▫ Lack of Fall prevention knowledge
▫ Lack of useful resources
▫ Lack of an upstream approach
Champlain LHIN
Champlain LHIN
Since 2013, we: • Developed a set of Champlain Fall Prevention Tools • Screening using Staying Independent Checklist • Assessment and intervention algorithm (now embedded in an
EMR) • Website www.stopfalls.ca • Exercise class navigation tool • Inter-professional communication tool • Ambulatory Care Fall prevention screening • PSW education module • CME for physicians • Next steps to build sustainability and embed use of
Champlain Tools into practice e.g. Primary care, Emergency Departments
Strategic Framework 2013-15
Pillar 1
Public Awareness
Pillar 2
Detection, Diagnosis,
Intervention
Pillar 3
Best Practices for Health
Care Providers
Pillar 4
System Navigation
Pillar 5
Performance Management
Pillar 6
Advocacy
Well Seniors Seniors at Moderate to High Risk of Falls
Falls Prevention Services along the Continuum of Care
Available across sectors Community
Care & Public Health
Primary care
CCAC Hospital Tertiary
care
Long-term care
2016 adopted Stay on Your Feet model
Champlain LHIN
Rates per 100,000 seniors over age 65
2014/15 2015/16 LHIN Rank
2015/16
Falls related
visits to ED
66.8 65.9 12
Falls related
admissions
1400 1300 11
Falls related
admissions from
LTC
2456 2469 5
Champlain LHIN
Champlain LHIN
Lessons learned and next steps: • A new vision and framework for 2025; adopted Stay on Your
Feet • A further gap analysis across the continuum shows that we
need to build in sustainability • Champlain has 20% of Ontario Retirement home residents,
need to plan accordingly • Standards that can be adopted for regional needs are key
factors for: • Training and education • Screening and Assessment • Intervention/ program content and delivery • Need to prevent duplication of effort within and outside our
LHIN
“For the last 5 years, the NE LHIN age-adjusted falls rate is consistently
higher than the province.”
www.nelhin.on.ca/stayonyourfeet
North East LHIN
“For the last 5 years, a higher rate of NE LHIN seniors are being hospitalized
for falls than in the province.”
North East LHIN
www.nelhin.on.ca/stayonyourfeet
www.nelhin.on.ca/stayonyourfeet
North East LHIN
• 2009, Aging at Home investment in two
Public Health Units(PHUs)
• 2013/14 – 5 PHUs agree to work with NE LHIN and adopt
the best practice framework – Stay on Your Feet (SOYF)
• 2014 – NE LHIN hires full time coordinator and a 3 year
MOU is signed with the 5 PHUs
• 2014 Regional SOYF Committee (all sectors and
geography) formed to oversee strategy
• Community Assessment Survey and draft 3 year plan
prepared (2015 – 2018)
NE LHIN Framework
Population-Based
Health Promotion:
5 pillars
www.nelhin.on.ca/stayonyourfeet
North East LHIN
www.nelhin.on.ca/stayonyourfeet
North East LHIN
Lessons learned
• It takes a community…to prevent a fall
• Change happens at the speed of trust – it takes time
• Build on each partner’s strengths and share the workload
• Engage older adults immediately
• Integrate quality improvement processes - start small, apply test of change, learn and spread (PDSA)
Next Steps
• New Regional Strategic Committee – new mandate /membership; working provincially to reduce duplication
• Year 3 priorities, sustainability and evaluation of SOYF
South East LHIN
Impact of falls • In 2014/15, there were about 7,000 falls-related
emergency department (ED) visits among those aged 65+ in the SELHIN ▫ Rate of 69 visits per 1,000 people aged 65+ 2nd highest
LHIN rate • About 22% of all falls-related ED visits for SELHIN
residents had a previous visit within the last 12 months ▫ Similar to the provincial rate
• In 2014/15, there were about 1,600 falls-related hospitalizations among those aged 65+ in the SELHIN ▫ Rate of 16 visits per 1,000 people aged 65+ 9th highest
LHIN rate
History
2013-2015
• Regional collaboration with PHUs to support planning for publicly-funded exercise and fall prevention classes.
• Small stakeholder group convened to gauge interest in a regional strategy.
• Stakeholder forum to gauge interest & support planning and development of a regional fall prevention & management strategy.
• Environmental scan of existing programs and services available in the South East.
• Multi-sectoral strategic planning session to identify the purpose, scope, aims, objectives and activities of the strategy.
2016
• Draft strategy presented to stakeholders via webinar; validated direction & feedback provided through webinar & survey
• Consultation on strategy implementation planning
• Webinar and survey to inform & consult with regional stakeholders on strategy development
• Report to stakeholders including updated strategy & overview of progress to date.
South East LHIN
South East Regional Integrated Fall Prevention & Management Strategy
South East LHIN
6 Key Activities
• Development and launch of
fall prevention microsite on
South East HealthLine
• Fall Prevention Month
(FPM) email campaign
promoting the FPM online
toolkit, launching the
microsite & disseminating
the report to stakeholders
South East LHIN
Next steps for 2017
PILLAR INITIATIVE
Public Education &
Awareness
Evaluation of Fall Prevention Month campaign to inform
direction of 2017 activities targeting consistent messaging on
the prevention, risk & impact of falls
Service Navigation &
System Integration
Full implementation of the fall prevention microsite – garnering
user feedback; promotion and sustainability planning
Provider Skill
Development &
Education
Further development of environmental scan & gap analysis of
education opportunities
Assessment &
Management
Exploration to identify key stakeholders & best practices
Engagement & Advocacy Development of engagement strategy for older adults
Engagement & communication with stakeholder groups to
validate & prioritize activities and operationalize the strategy
South East LHIN
Are there any clarification
questions for our presenters?
1. Type your questions into the chat box
2. Dial *7 on your telephone keypad to unmute
your line. Please dial *6 when you are finished
speaking to re-mute your line.
• Leveraging existing knowledge, skills, and
resources
• Greater impact on falls and falls-related injuries
in older adults in Ontario
• Older person first and system-wide thinking
made easier
• Going to scale: working together and learning
from each other province-wide
Value Proposition: Group Discussion
2 Polls
Here
• How could you be involved?
• Do you have other thoughts or suggestions?
Open Discussion
1. Type your questions into the chat box
2. Dial *7 on your telephone keypad to unmute your line.
Please dial *6 when you are finished speaking to re-
mute your line.
Important Contacts
Dr Paul Roumeliotis: • [email protected] Ontario Neurotrauma Foundation: Hélène Gagné, • [email protected] Champlain LHIN: Christine Bidmead & Dianne Rossy • [email protected] & [email protected] North East LHIN: Wendy Carew, • [email protected] South East LHIN: Megan Jaquith & Rhonda Lovell • [email protected] & [email protected] Loop: www.fallsloop.com or www.chutesloop.com