This aspect of patient care was prioritised due to a quarterly rise in the number of falls. Although this rise was small it was considered timely to review our approach to caring for our vulnerable patients.

The improvement plan achieved by March 2015 aimed to

• Re-establish the multidisciplinary Falls Group to focus initially on the In-Patient Unit (IPU) Falls Pathway and lead educational packages necessary to embed the Pathway in practice.

• Review the current literature on falls prevention ensuring that the pathway developed reflects evidence based practice. The Help the Hospices Falls Toolkit (2012) and the current NICE Clinical Guidelines 161 Preventing Falls in Older People (2013) are key drivers in this development.

• Review, develop and embed the assessment process for people at risk of falls, ensuring that a comprehensive risk multi factorial evidence based assessment is fully implemented in practice.

• 100% of IPU patients will be risk assessed in compliance with the falls standards and pathway.

• Review and develop the use of a multidisciplinary management plan to reduce the risk of falls where possible.

• Develop standards of practice to reduce the risk of falls where reasonably practicable for all patients in our care including review of pharmaceuticals. Compliance with these standards and the quality of care given will be assured going forward via audit.

• Develop and embedan evidence based post-falls protocol to ensure that all patients are assessed and treated in line with best practice

Next steps Evaluate project to date in June 2015 making adjustments as necessary before developing the Day.