Transcript File

THE FOUR COSTS OF A
FALL
Scott Lipps
Annual Conference 2010
What we do to engage a site:
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Introduction of our team
Thank all attendees for their time and
interest
Encourage participation and eating the
goodies
Try to become a part of their team
Stay positive
Use appropriate terms to your setting
Long Term Care=F-Tags and State Surveys, MDS
Acute Care=JCAHO, Quality Indicators
Introduction
Over the past several weeks, we have
been meeting with your management
team regarding falls, your current Fall
Program and fall-reduction products.
Your DON (insert name) asked us to
spend a few minutes with you to
discuss just how serious falls are for
our residents/patients, staff and
facility.
Setting the Stage
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First, please understand that your management team clearly
recognizes that you have done a great job with the resources
allocated toward fall reduction. In our meetings, we heard
several times that management has asked you to do more
with less and staff has responded time and time again. This
meeting is solely intended to remind everyone just how
serious falls are and look at the real cost of a fall. We were
reminded of the old axiom, “out of sight, out of mind.” Well,
we must keep falls on the radar screen looking for ways to
improve procedures and reduce falls.
When you think of the term, Cost of a Fall, it is only
natural to think of a dollar sign. Everything is measured in
costs and in today’s economy costs are discussed everyday.
The problem is, with falls, the costs are much greater than
just that dollar sign. We see Four Costs to a Fall.
The Human Cost:
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Falls create tremendous problems for
the patient. Obviously, it hurts to fall.
Look around…there are a lot of places
to get hurt! Everything is wood,
metal, steel and concrete with corners
and edges. Often, falls are painful,
cause lacerations, injuries, brain or
head trauma, fractures and even,
death.
The Human Cost:
Often, falls are painful, cause
lacerations, injuries, brain or head
trauma, fractures and even, death.
 It hurts to fall. Lacerations can bleed,
patients can go into shock, and
injuries can be severe with fractures
or worse.
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The overlooked side effect: FEAR!
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A fall can create fear so strong that a patient will
not do their normal routines, hoping not to fall
again.
These decisions lead to a lower quality of life and
the “use-it-or-lose-it-syndrome.”
Fear can manifest itself in another way: After a
fall, have you ever had a patient ask you not to tell
their son, daughter or doctor?
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“Oh, please don’t tell my family, I promised them I would
ask for help, and I just forgot. I don’t want them to know I
have fallen or to be mad at me.”
Or, “please don’t tell my doctor. After my last fall they
changed my medication and I became confused. I didn’t
really know where I was. I don’t want to go through that
again…it was scary…please don’t tell on me.”
Fear changes people…
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Now, we have this elegant patient,
everyone liked and enjoyed, reduced to
child-like pleadings to not get in trouble.
That is not why patients select (insert
name of facility) for their healthcare
needs!
The Second Cost: Staff
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Let me ask you, do you believe we are
over-staffed?
 Do you have free time just waiting for the
next fall so you can start interviews and
incident reports?
 What I see and many of you have told us,
is that within the first 15 minutes of your
shift you are behind. Most days, you
wonder how you are going to get half of the
things done that you need to address.
Falls add tremendous stress to our staff.
Staff feel the effects of a fall…
Your management team explained to us that you have
tremendous responsibilities and how hard you work to
achieve them. Falls hurt our patients AND they hurt our
staff. Even simple falls require time and staff attention. We
must address the patient, their needs and any injuries. We
must interview everyone in the area, ask questions about
physical environment, and complete an incident report and
contact family and physicians. Who is doing your job while
all of this is taking place? You are getting farther behind and
the stress is building. To make it worse, add in little things
like feelings of sadness or remorse that a patient was injured
on your watch or on your floor. You didn’t get into
healthcare to see people injured. You have that “calling” to
help others that we often discuss. Well, working at (name of
facility) maybe you got into it for the big money! Falls create
tremendous stress and issues for staff!
The third cost of a fall…
…is that dollar sign that we talked
about a few minutes ago
Money, Money, Money, Money
Big
Yes, falls cost money! ----money.
 Small falls cost money.
 Big falls cost more money!
 Falls cost the patient, family and
insurance companies
 Medicare/Medicaid, our facility and
even YOU, money!
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Falls increase the cost of care.
Somebody…everybody has to pay that increased
cost. The patient pays more, their family pays
more, the primary funding source pays more,
and costs to our facility increase. Anything that
consumes the resources of (insert name of
facility), detracts from the funds available for
bonuses, raises and benefits! Falls start costing
money from the minute they happen. TIME is
expensive in health care. Falls require time.
Before we move on let’s really bring the financial
cost of a fall into perspective:
Quantifying a fall…
Do you know how much the average hip
fracture costs? Well, most recent
data says, depending on what state
the injury occurs in, the average hip
fracture costs $30,000! Falls are
financially expensive to our entire
healthcare system and economy.
The cost we all know…
The Legal/Lawsuit issue.
 Today, we sue everyone for everything.
You know the stories:
 People sue because their coffee is too hot,
their child got cut from the cheerleading
squad, they don’t like their boss and more.
People sue everyone associated with a fall.
They sue the facility, the product
manufacturers and YOU!.
Lawsuits R us!
I was traveling last week in
Chattanooga, Tennessee and caught
the late news. One of the opening
commercials was an attorney asking
if you had ever been scared, felt
threatened or had been bitten by dog.
The attorney was trying to get the
viewer to find some way to sue
someone related to dogs
And the story continues…
The middle commercial break featured
a different attorney asking about
motorcycles (accidents, problems,
issues, etc). Again, the attorney was
prompting people to find a way to sue
other people for something related to
motorcycles
An easier target???
The close of the news cast featured a third
commercial, by a different attorney…and this is
the worst one. You have all seen it. The attorney
was asking about long-term care. Do you have a
loved one in a long-term care or nursing facility?
Do you know how they are treated when you are
not there? The attorney named a long list of
problems that “may” be happening to the
residents (bruises, injuries, mental and emotional
abuse, sexual abuse, improper use of medications,
falls, wounds, and more).
The message effects us all…
The commercial made me sad for what our
world has come to and mad because I
know how hard people in healthcare try.
Several of you are thinking that I am trying to
scar you or blow this out of proportion.
Sure, there are lawsuits but that happens in
California and New York, not here in the
Midwest. We take care of each other, bring
in the mail for each other and even shovel
the sidewalks for our neighbors