Category 2 – Health Promotion and Early Intervention
Sponsor: Spotless Laundry Services WA
Finalist: The Falls Prevention Health Network and South Metropolitan Public Health Unit Ambulatory Support Team
Project: The Falls Specialist Program
Each year around a third of people over 65 who live at home will experience a fall. The Falls Specialist Program, which targets older people at risk of, or experiencing falls, provides an integrated service across a range of inpatient subacute care, community care and area health service settings.
The program aims to reduce the incidence and length of hospitalisation due to falls. It provides multifactorial risk assessment and targeted interventions such as balance exercise programs and home assessment. The Specialist Coordinator Program Lead, although based at Sir Charles Gairdner Hospital, supports services across the north and south metropolitan areas.
The mean age of referrals is 81. From 2009 to 2013, 1642 referrals were received across the metropolitan area. After six months, 500 clients were followed up and the data showed a reduced prevalence of falls; in fact, 62 per cent experienced no falls at all after participating in the program.
The role of a Falls Specialist can be filled by a range of allied health disciplines, working in an integrated manner across sites with their colleagues in the program. The Falls Specialist Program, initially funded under NPA Schedule C from 2009 to 2013, has received further funding under Schedule E for the period 2011 to 2015.
Finalist: Fremantle Hospital and Health Service
Project: Patient Blood Management
Blood and blood products are precious resources in hospitals. There is no question that blood components have saved many patients’ lives, but they can also pose a risk to patients. The Patient Blood Management program (PBM) at Fremantle Hospital and Health Service, established in the 2009–2010 financial year, aims to minimise unnecessary exposure to blood components in the interests of patient safety, while also conserving these products for patients who need them most.
PBM applies a patient-centred approach. A multidisciplinary team works with the patient to develop a management plan to a) optimise the patient’s blood volume; b) minimise blood loss; and c) optimise tolerance of anaemia. The team applies a number of interventions at the pre-operative, operative and post-operative stages to reduce the need for transfusion of blood products to the patient.
PBM at Fremantle is achieving its aims. In June 2012 an evaluation by external auditors confirmed that between 2008 and 2011 the number of red blood cell units per admission decreased by 26 per cent. The single unit rule (in which only one unit of blood can be ordered if a patient is not actively bleeding) has become an established practice, and is now being emulated in other hospital sites in WA.
Finalist: Communicable Disease Control Directorate and King Edward Memorial Hospital
Project: Protecting Mothers and Babies Through Antenatal Influenza Vaccination
In 2012, the World Health Organization’s Strategic Advisory Group of Experts on Immunisation stated that pregnant women are the most likely to benefit from influenza vaccinations. However, only 23 per cent of pregnant women in WA were vaccinated against flu in 2012.
The single most important reason for this low rate is that flu vaccine is not routinely recommended or offered by antenatal care providers. King Edward Memorial Hospital (KEMH) and the Communicable Disease Control Directorate (CDCD) developed a number of strategies to improve pregnant women’s access to and acceptance of flu vaccine.
Underpinning this initiative was an operational directive ‘Influenza Vaccination for Pregnant Women’. The operational directive authorised midwives, registered and enrolled nurses to administer influenza vaccine. To inform staff of the operational directive, staff development sessions were arranged. The awareness-raising campaign was supplemented by posters and pamphlets distributed in hospitals and health services.
As another strategy, pregnant women in inpatient and outpatient settings throughout KEMH were offered free flu vaccines. By late July 2013, 780 women had received vaccinations at KEMH – a 61 per cent increase over 2012 (and vaccines were still being offered until the end of August). The increased rate of vaccination is a pleasing outcome, as antenatal flu vaccination prevents one case of serious maternal or infant respiratory illness for every five pregnant women who are vaccinated.
CDCD has been following up with vaccinated women to ensure that the incidence of adverse events following immunisation is monitored.