48 A quality improvement project led by two foundation doctors aiming to improve the quality of actions taken following an inpatient fall on davenport and rosewood wards, the meadows. (3rd November 2019)

• Record Type: Journal Article
• Authors: Cox, Mark; Azmy, Jessica
• Is Part Of: BMJ leader. Volume 3(2019)Supplement 1
• Page Start: A18
• Page End: A18
• Publication Date: 2019-11-03
• Subjects: Medical personnel -- Periodicals; Leadership -- Periodicals; Medicine -- Practice -- Management -- Periodicals; Health services administration -- Periodicals; 610.68
• DOI: 10.1136/leader-2019-FMLM.48
• Languages: English
• ISSNs: 2398-631X

Abstract

Abstract : Objectives: Our aim was to run a successful quality improvement project and improve patient care over two inpatient wards at The Meadows Community Psychiatric Hospital, Stockport. Background: There is an average of 38, 000 falls each year in community hospitals across the UK which Results in high levels of morbidity and mortality. We noted that the quality of post-falls reviews taking place by doctors at The Meadows varied greatly and were often not meeting NICE guidance on multifactorial risk assessments for falls, potentially leading to patient harm. Methods: Initially, we reviewed 34 inpatient falls by retrospectively analysing patients' notes in January 2018. Following this a post-falls pro forma was designed and implemented to guide doctors when performing their reviews. Feedback was collected, education sessions delivered and changes made accordingly. We then reviewed a further 20 falls on the same wards over March-April 2019 and improvements over 11 NICE standards were recorded. Results: The quality and consistency of falls reviews improved in all but 1 of the 11 NICE standards and 5 categories achieved 100%. These included receiving a medical assessment < 12 hours post fall, sending for a CT head if appropriate, performing neurovascular and cardiovascular examinations and recording medical observations post-fall. In addition, 85% now met the standard of having a medication review as part of the intervention to prevent further falls when using the pro forma (compared to 24% when the project started.) Conclusion: Our project highlights that junior doctors can effectively lead and manage a successful project to improve patient care. Despite our junior status within the team, we were able to implement strong leadership and management skills and are currently expanding the project from its original objective to a Trust-wide project, reflecting its success.