August 18, 2017
“Get’n Mov’n” Program to Reduce Falls
“Get’n Mov’n” Program to Reduce Falls
The challenge and opportunity with long-term care is to develop individual resident-centered routines that not only honor each resident’s rights and encourage independence, but that also keep each resident as safe as possible. New Horizon Care Center in Lovell, WY has risen to this challenge.
New Horizon’s Fall Program has evolved over several years with a sustained diligence to continuing the trend of decreasing falls. On the plus side, New Horizon’s fall numbers have reduced substantially—however the number of falls with major injury was not decreasing at the same rate—instead they averaged 10 to 15 in Mountain-Pacific’s monthly reports with the CMS National target being six.
In February 2017, we viewed the webinar, “New Look at Managing Falls” by Sue Ann Guildermann, RN, BA, MA. Much of the webinar was similar to the areas we are already targeting and served to validate that we were on the right track through prevention, identifying appropriate interventions and conducting root cause analysis. However, one thing stood out—although counterintuitive, you have to get the residents up and moving. When you do, you will then develop their core, balance and endurance so when they do stand to walk they will be less apt to fall. This made sense. Our residents were already getting up—we just needed to keep them safe once they did.
To add this to our fall program, required everyone’s involvement. First, we solicited input of floor aides, the activity aide and the restorative aide. They were positive and thought it would work. The fall team of Traci Harrison, CNO; Vicki Croft, restorative nurse, RN; Activity Director, Aspen Beall; Debbie Salyer, MDS coordinator RN; and Michelle Horrocks, upstairs supervisor and RN, all committed to testing this new program.
We launched our “Get’n Mov’n” program in March 2017. Social Services Director, Cathie Nunn, kicked off the program by cranking up music to motivate and encourage our independent residents to walk. In no time at all, we were off and moving!
Our facility is unique in that it is set up perfectly for this program. We have hallways in a circle on each floor that are 360 feet in diameter. Residents are walking everywhere and with a little encouragement, many are walking anywhere from a half lap to several laps.
“Most new programs are typically met with resistance and barriers,” says Michelle Horrocks, RN, Supervisor at New Horizon. “As a team, we decided that rather than trying to anticipate what would be potential issues, we would just face the complaints as they came. There were some concerns from staff as we started, but much less than we thought. We either educated
the staff to the reasons of the program or made a few changes as needed. For the most part things went very smoothly,” Horrocks added.
We received comments about how nice it was to have leadership around in the morning. This also serves as a great time to see how the night went and how the residents are doing.
We saw positive outcomes almost immediately. The staff reported that the residents seemed happier and were stronger with transfers. At the beginning, it took three staff members to ambulate residents who have not been walking—within three months those same residents now require limited assistance of two staff.
We knew the change was a success with the May Mountain-Pacific report, which showed our falls with major injury rate was now at 8.22. This is a steady decline in three months. We will continue to monitor these numbers with a goal of further decreasing our numbers.
“’Get’n Mov’n” will be a long-term program for us. It is just the right thing to do. It benefits the residents, the staff, the families and leadership,” said Michelle Horrocks, RN, Supervisor at New Horizon.
The biggest lesson we’ve learned is to have faith in our residents and their abilities. Too soon and too often we take away our resident’s independence and opportunities in an effort to keep them safe. New Horizon Care Center realizes that, in the long run, this mindset is not to the benefit of the resident.
Our advice to other facilities? Try to adopt a similar ambulation program. It’s well worth it. As leaders, the biggest challenge you’ll face is being pulled in different directions. “Knowing that you’re keeping your residents safe and moving takes continued commitment, but making this a priority is one of the most important things you can do for the safety of your residents,” said Horrocks.
About Mountain-Pacific—Mountain-Pacific is a 501(c)(3) nonprofit corporation and holds federal and state contracts that allow them to oversee the quality of care for Medicare and Medicaid members. Mountain-Pacific works within its region (Montana, Wyoming, Alaska, Hawaii and the U.S. Pacific Territories of Guam and American Samoa and the Commonwealth of the Northern Mariana Islands) to help improve the delivery of health care and the systems that provide it. Mountain-Pacific’s goal is to increase access to high-quality health care that is affordable, safe and of value to the patients they serve. www.mpqhf.org