Abstract
Introduction
The Action Falls programme has demonstrated effectiveness in reducing falls amongst care home residents in a trial but has not been implemented widely (Logan et al, BMJ, 2021, 375, e066991). Co-production of implementation has been identified as a mechanism for achieving buy-in. This study aimed to co-produce an implementation model.
Methods
Systemic action research with an appreciative approach framed co-production workshops in three stakeholder groups: residents and relatives, care home staff and representatives from health and social care organisations. Topics explored were stakeholder priorities, design of the implementation model and evaluation outcomes. Data collection and analysis occurred concurrently to identify key themes. Participating stakeholders were invited to a celebration event to discuss key themes, share ideas and finalise the model.
Results
One action research cycle was completed. Eighteen workshops were undertaken with 16 stakeholders (7 care staff, 7 health and social care representatives, 1 resident and 1 relative). Falls training was reported as an area requiring improvement. The main priority identified was the need for a shared approach to learning about falls. Other themes were: tailoring training to individual and care home learning needs, involving key people in falls learning, safe spaces to share experiences and build relationships, providing regular learning opportunities, confidence in falls management as an appropriate measure of implementation success, and the need for a mixed methods approach to evaluate the model. A shared learning model was developed at the celebration event. The model included three components: accessible information for residents and relatives, bespoke training for each care home, and provision of ongoing support.
Conclusions
A shared learning model was co-produced as part of the Action Falls implementation strategy. This now needs evaluation.
Comments
Congratulations
Very nice to see this co-production approach to identify the learning required to reduce falls in care home. I am sure this will result in much more engagement with the learning programme in the end. I hope you have data of falls frequency and type prior to the intervention so that you can monitor changes.
I wondered if you have considered increasing the numbers of relatives involved in the next phase given that they may be able to both help their loved one whilst they are visiting but also identify when their carers are not proficient
Thank you for your comment and interest in this work.
In this next stage, we are collecting case studies to explore different approaches to implement the bespoke and ongoing support components of the learning model in practice. This includes a new falls lead role and a community of practice. Based on the stakeholder's prioritisation of outcomes in the co-production workshops, our primary outcome for the next research cycle is changes in confidence among care home staff. We are evaluating this using pre and post surveys, interviews and observations.
We are planning to involve residents and relatives in greater numbers and agree that relatives bring valuable experiences and expertise. We plan to work with established networks and partnerships to achieve this, such as ENRICH, and will work with residents and relatives to develop falls information resources.