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. 2009 Nov 14;2009:153–157.

Table 1:

Fall TIPS Toolkit (FTTK) Spread Strategy

“Spread for Change” Component1 Fall TIPS Toolkit (FTTK) Spread Strategy
Leadership: Setting the agenda and assigning responsibility for spread

  • CNO sets expectation for change and assigns responsibility for spread and adoption of FTTK.

  • Unit-based nursing leadership consistently reinforces expectation.
Set-Up for Spread: Identifying the target population and the initial strategy to reach all sites in the target population with the new ideas

  • Involvement of stakeholders in identification of FTTK requirements, usability testing and pilot testing on experimental units.

  • Use of PHS Fall Prevention Task Force as advisory committee and hospital based fall prevention committee members as consultants.

  • Development of FTTK to translate fall prevention interventions and to align effective interventions with patient-specific risk factors and existing workflows.

  • “Just-in-time” round the clock training for professional and paraprofessional caregivers on use of FTTK.
Better Ideas: A description of the new ideas and evidence to “make the case” to others

  • Fall prevention interventions directly linked to nursing fall risk assessment. FTTK tools (e. g. bed posters and patient education handouts) auto-print once initial nursing fall risk assessment is filed.

  • Icons are used to communicate recommended interventions in format that cuts across literacy levels of care team including professional, paraprofessional caregivers, patients and family.

  • Web and paper-based competency developed to facilitate training and to support different styles of learning.

  • In-service education provided for professional/PPS caregivers by unit-based “peer champions”
Communication: Methods to share awareness and technical information about the new ideas

  • Consistent, sustained message from unit-based leadership team that building a culture of safety and evidenced by adoption of FTTK is a top priority on PHS system and hospital levels.

  • Meetings with stakeholders: PHS Fall Prevention Task Force serves as advisory board, hospital-based fall prevention committees facilitate local communication; unit-based staff meetings, “Fall TIPS Safety Rounds”.

  • Unit based champions: 1) piloted FTTK and participated in iterative design, 2) communicated benefits to peers including fall prevention interventions tailored to patient-specific areas of risk and limited to those with evidence-base and identified in focus group as “feasible”.
Social System: Understanding the relationships among the people who will be adopting the new ideas

  • Focus group interviews to identify social, cultural and educational barriers to fall prevention across stakeholders (e. g., professional and PPS caregivers, patients and family members).

  • FTTK requirements based on focus group transcripts.

  • FTTK integrated into existing workflows.
Knowledge Management: Observing and using the best methods for spread as they emerge from the practice of the organization

  • Employing an iterative approach to supporting spread and adoption of FTTK with hospital based teams and unit-based “peer champions”.

  • Chief Nurse Council sponsored annual “PHS Safety Summit” with presenters from local hospital implementation teams.
Measurement and Feedback: Collecting and using data about process and outcomes to better monitor and make adjustments to spread progress

  • PHS adopts “falls” and “ falls with injury” as “PHS High Performance Measures”, requiring system-wide reporting.

  • Unit-based teams involved in evaluating adherence with FTTK protocol and identifying/implementing improvement plans.

  • Weekly email to nurses to report on adherence with FTTK protocol.