Using Quality Improvement to support the implementation of the Action Falls programme in care homes

Introduction

Care home residents, who are often frail, are three times more likely to fall than those living in their own homes. An intervention programme (Action Falls) consisting of a checklist and training, using a co-design approach, was developed to help prevent falls in care homes. A series of studies explored the effectiveness (Falls in Care Homes Study), the implementation (Finch Implementation Study), and sustainability of training the trainers (Action Falls Lead Training Evaluation). Throughout the life course of this series of studies a Stakeholder group met every three months, consisting of care home management (n=1), residents (n=1), Falls Leads trainers (n=4) and Patient and Public Involvement partners (n=4). This group played an important consultancy role with five to ten Stakeholders attending each group. 

Methods

The Stakeholder group is a care home population guiding, informing and influencing the conduct of the research. The group received questions from the Study Steering Group, answered those questions, and posed their own questions back to the Study Steering Group. They have also been influential in the development of the programme’s Toolkit and study infographic.  

Results

The questions included: how to widen participation to underserved communities, how to reduce the degree of burden exerted upon care homes, how the intervention should be funded and who should take responsibility, if staff should be paid (and if so by whom) if attending training on non-work days, and the cost and practicality of releasing staff from care to complete the training. There were considerable changes to the protocols, dissemination of results and impact on care directly informed by the Stakeholder group.

Conclusion

The two-way communication between the Stakeholder and Study Steering Group ensured that practical considerations, and long-term sustainability issues, were considered throughout the life cycle (2015-2026) of the studies.