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Reducing patient falls – our safest month yet

Friday September 15, 2017

Falls reduction – message to Western Sussex Hospitals staff from Dr George Findlay, Chief Medical Officer

Dear colleagues,

Last week was the best week we have ever experienced in terms of patient falls in our hospitals with 18 falls recorded.

Of course, 18 remains 18 too many, but two years ago, before we started our Patient First falls reduction work, nearly 60 patients fell in the same week while in our care.

That’s an incredible 70% reduction and while that figure is not truly representative due to the natural week-to-week variance in falls there can be no denying the overall trend.

August was our safest month yet, with 129 patient falls recorded. July was close behind with a total of 135 falls. Furthermore, these achievements follow a superb year-on-year reduction of 30% in falls during 2016/17.

It is important to remember that colleagues are making these improvements at a time when we are caring for more and more patients who are also getting older and more frail. This clearly demonstrates the benefits of our Patient First lean approach which led us to focus on the priorities we believed would make the biggest difference to our patients.

Even more remarkable than the actual reduction in falls has been the positive cultural shift we have observed

In the NHS it is not uncommon to be challenged with 1,001 priorities all at the same time which actually results in nothing being a priority. Patient First forces us to question what are our real priorities are – these are our True North goals.

We determined that reducing avoidable patient harm would be one of our streamlined main focuses and, after studying the data, it was clear that patient falls were the biggest contributor to avoidable harm.

A fall in hospital is a traumatic occurrence which can hugely set back recovery and cause broken bones and even death. We therefore said we would focus on reducing falls and we would not turn our attention to another priority until we had made a significant impact. The results are plain for all to see.

However, to my mind, what has been even more remarkable than the actual reduction in falls has been the positive cultural shift we have observed across the trust. In the past, a pernicious attitude could sometimes take root, such as: We care for older patients and so falls are to be expected.

This is clearly proven wrong by the success of our shared drive to reduce patient falls. Instead, what I experience now is colleagues both saying and believing that one fall is one too many.

Well done to everyone involved in the falls reduction work – you are achieving remarkable results and saving hundreds of patients from terrible avoidable injuries.

I stated earlier how reducing avoidable harm was one of our key True North goals. One of the ways we measure this is the hospital standardised mortality rate, or HSMR as compiled by Dr Foster.

At the outset we gave ourselves the target of being in the top 20% of best-performing trusts – our latest figures, from the month of May, now put us within the top 12% of trusts nationwide. And we can further improve still.

Wednesday this week was World Sepsis Awareness Day. Colleagues from across the trust participated in various activities to raise awareness and help improve sepsis care. The detection of sepsis and, more importantly, early treatment is an area we can and already are improving upon.

All clinicians have a role to play in our fight against sepsis and I encourage HCAs, nurses and doctors to sign up to the acute illness management and perfusion study days as well as sepsis simulation training.

I am now looking forward to writing a similar message this time next year reflecting on our successes tackling sepsis and other avoidable harms that will lower our mortality rate further still and put us into top 10% of best-performing hospitals in the country on this important measure.


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