New resources to support safe care for older people
29 July 2024
A series of videos highlighting the Clinical Excellence Commission (CEC) Comprehensive Care- Minimising Harm (CC-MH) model has been developed to support frontline staff in providing safe care for older people.
An ageing population is leading to more hospital admissions for older people, often with multiple medical conditions. The CC-MH video series takes a holistic approach to providing safe patient care, leading to a reduction in falls, pressure injury, delirium and malnutrition.
Comprehensive Care – Minimising Harm Model resources
Topics in the video series include an overview of the CC-MH model, patient care fundamentals and intentional rounding, building blocks for a safe ward, nutrition and hydration, cognitive impairment with a focus on delirium, safe and early mobilisation, person-centred care, 'what matters to me' and post fall management.
Case study: structured approach to improved care and reduce falls
Wyong Hospital, Central Coast Local Health District worked with the CEC Older Persons' Patient Safety Program using a quality improvement approach to reduce falls on the Neurology and Acute Stroke Unit, H4A.
The ward team considered the CEC CC–MH model to identify where improvements could be made. The Nurse Unit Manager Erin Perrot said the process helped address a rise in falls after a recent move to a new ward environment with long corridors, single rooms with more complex patients.
"Our first step was to get a holistic view of the way we worked," said Erin.
"A structured approach to identify issues as a multidisciplinary team and review fall incident data was important. We found opportunities to improve in terms of staffing allocation and communication.
"We then developed potential change ideas which we tested, adapted and improved over time. We started small, and as we learned more, expanded to cover the whole ward."
The team reviewed the staffing allocation and divided the two ward nursing teams into three smaller teams, more suited to the changed layout of the ward. They changed the start time of one of the morning staff to 6am to assist patients out of bed and to the toilet. This was to address high fall risk activities at a high fall risk time period identified by the program.
Communication in the ward was improved with bedside and ward communication boards, highlighting patient care needs such as mobility and cognitive status, vision /hearing and dietary requirements. The communication boards were developed iteratively over time to show important information in a clear format for all staff as well as patients, family and carers. These changes were embedded through strong commitment by the nurse leaders including Clinical Nurse Consultant for Neurology Margie Fletcher and the clinical nursing team who saw the benefits to workflow, communication, patient care and outcomes.
Leticia Bailey, Operational Nurse Manager at Wyong Hospital.
"I am very proud of the achievements of the team," said Leticia.
"By providing training and support in quality improvement and empowering the team, we have made care safer for our patients and reduced falls in the neurology ward."
"We are also looking to expand some of the initiatives to other wards in the hospital and to other hospitals in the Central Coast LHD," she said.
The improvements made on the neurology ward included many elements from the CEC Comprehensive Care – Minimising Harm Model. For more information, visit the CEC Older Person Patient Safety Program page .
The ward H4A team, Wyong Hospital.