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Quality improvement opportunity

Reason for the Need for Quality Improvement

The main reason for the need to improve is to reduce the fatalities caused by patient falls and reduce the cost of care. In most cases, the patients who are at risk of falls include those who are advanced in age, multiple pathologies, and that post-surgical operation. When these patients suffer from falls, they end up being exposed to a poorer prognosis. The management of the resultant pathologies as a result of the fall overburdens the patient even more. The management approaches have also to be adjusted to fit the new needs of the patients. For instance, a bed-ridden patient due to the presence of a fracture has to be offered more primary care to prevent the development of bedsores. Such adjustments strain both the clinicians and the patient.

The reduction in the cost of care is another target of this program. The management needs that are brought about by the fall constitute part of the care that can be avoided with the adjustment of primary care. When the primary care providers and the patient work together to troubleshoot the environmental aspects that constitute a risk to falls, the cost of care is minimized to the management of the current disease. The length of stay at the facility is also restricted to a minimum based on the needs of the patient and the nature of the initial illness.

Previous Research on the Topic

In research to explore the fall rates in patients postoperatively when there was a positive history of pre-operative fall, Vanessa L. et al. (2016) found a positive relationship. In this research, the target population was patients undergoing elective surgery. The patients’ histories pre-surgical were reviewed for a history of falls, and the participants followed for a duration of one year. The results showed that the presence of a history of falls pre-surgery increased the chances of the patient suffering from a fall after the procedure (Kronzer, 2016).

In research to assess the impact of patient education on falls in a comprehensive care ward, the researchers aimed at comparing two elderly populations. The intervention group received education on fall prevention through leaflets and watching a DVD. During assessment for knowledge of fall prevention strategies, the intervention group showed high levels of knowledge compared to the control group. The intervention group also showed higher adherence to fall prevention measures (Shim, 2019).

In research evaluating the perceptions of the patients in regard to falls when they are in the care facility, and after discharge, the researcher explored the knowledge. The points assessed included whether the patient had received education on prevention measures and the need to practice them. The patients were also assessed for the practice of fall prevention measures. The results of the study were qualitative and varied between respondents.  Based on the results, the researchers proposed the development of a platform that allowed more communication between the patients and the clinicians on falls. The involvement of the patients in the prevention process would help in reducing the incidence rates (Shuman, 2016).

Steps Necessary to Implement the Changes

In this project, Lewin’s model of change will be applied. In this model, the targets of the change process undergo unfreezing, change, and refreezing (Hussain, 2018). In each stage, the management has to ensure that the members of the organization follow through with the management of any hurdles to the change process being handled as they crop up. It is also crucial to allow time for the change process and be prepared for the hardships that change faces, especially in clinicians who have practiced for a long time. They tend to be more unwilling to change by virtue of having a method that has always worked.

The unfreezing stage involves the explanation to the rest of the workforce about the need for change.  It is crucial to ensure that the workforce understands the possibilities that change would bring to the outcomes of the patients. In this case, the effects of falls and the possibility of improvement have to be explained. Other care settings that have succeeded in reducing the rates of falls by adjusting primary care delivery can be used for benchmarking.

The changing process includes switching the care delivery approaches in favor of seeking targeted outcomes. In this case, it includes the use of a checklist to ensure that the environment does not predispose the patient to falls, the use of 24 hour supervision for patients who are at risk of falls, the notification options that the patient can contact the caregivers with when they need help to move, and the education of patients about falls.

The refreezing involves the maintenance of the new culture in the care of the patients on a long term basis. At this stage, the management monitors the rest of the team for the demonstration of the targeted care behavior. The management has to also ensure continuous training for the maintenance of the care delivery at the attained standards.