Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
MY Chan(1), MW Yau(1), WH Wong(1), MK Lam(1), CW Ho(1), CN Cheung(1), YY Kwok(1), PC Ling(1), SM Leung(1), K Chan(1), J Suen(2), C Choi(2), E Chan(2), J Cheung(3), C Mak(3), Ada Tsui(3)
Affiliation :
(1)Department of Tuberculosis & Chest (DTBC), TWGHs Wong Tai Sin Hospital (2)Department of Occupational Therapy, TWGHs Wong Tai Sin Hospital (3)Department of Physiotherapy, TWGHs Wong Tai Sin Hospital
Introduction :
In 2022, it was observed that 45% of falls were occurred in the department among patients without cognitive impairment, and these falls were considered preventable. Existing literature emphasizes the significance of multidisciplinary teams and patient involvement in enhancing patient safety and preventing falls. Therefore, the SMILE program has been implemented with the aim of reducing fall incidents through active patient engagement and the adoption of a multidisciplinary approach.
Objectives :
1. To foster and sustain a patient safety culture and lower fall incidence rates in patients without cognitive impairment. 2. To enhance patient satisfaction and knowledge related to fall prevention.
Methodology :
“SMILE” program adopted collaborative strategies. Patients without cognitive impairment were actively involved in fall risk assessments, setting goals, training, and feedback. The program also adopted a multidisciplinary approach, incorporating the expertise of professionals from different disciplines including nurses, physicians, physiotherapists and occupational therapists. SMILE program (1) Patient “Safety” was promoted in fall prevention. (2) Regular “Multidisciplinary rounds” were implemented to develop patient-centered care plans. These plans were tailored to individual goals, specific needs and risk factors. (3) Nurse “Identified” the target patients who are at risk of falls and the risk factors associated with falls. (4) “Learning” from evidence and case studies of fall prevention. Patient and their caregivers received education and support to implement effective fall preventive measures. (5) Patient “Empowerment” was achieved by active involvement, continuous engagement and maintaining a collaborative relationship with patients. Continuous monitoring of fall rates and collecting patients’ feedback were integral to the program. Interactive discussions with multidisciplinary teams were conducted to ameliorate the program.
Result & Outcome :
After the implementation of the SMILE program, no fall incidents were observed among patients without cognitive impairment in the department from May to November 2023. All 49 patients who recruited into the program demonstrated enhanced awareness and knowledge of fall risks and preventive measures. Additionally, all patients expressed satisfaction with the SMILE program. Conclusion: The "SMILE" program has resulted in a significant reduction in fall incidence among patients without cognitive impairment. The active patient engagement and multidisciplinary approach strategies played crucial roles in fall prevention. Patient satisfaction and knowledge regarding fall prevention have been enhanced. The patient safety culture in fall prevention is fostered and sustained after implementing SMILE program.
