Prevention Planning: Beyond the Provincial Framework February 22, - - PowerPoint PPT Presentation

Inter-LHIN Collaboration in Fall Prevention Planning: Beyond the Provincial Framework

February 22, 2017

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Welcome & Introduction

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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

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

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.”

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

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

North East LHIN

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

• f 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

• n 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:

• proumeliotis@eohu.ca

Ontario Neurotrauma Foundation: Hélène Gagné,

• helene@onf.org

Champlain LHIN: Christine Bidmead & Dianne Rossy

• cbidmead@toh.ca & drossy@toh.ca

North East LHIN: Wendy Carew,

• Wendy.Carew@LHINS.on.ca

South East LHIN: Megan Jaquith & Rhonda Lovell

• Megan.Jaquith@LHINS.on.ca & rhonda.lovell@kflapublichealth.ca

Loop: www.fallsloop.com or www.chutesloop.com