Using a community of practice to evaluate falls prevention activity in a residential aged care organisation: a clinical audit
Jacqueline Francis-Coad A F , Christopher Etherton-Beer B , Caroline Bulsara C , Debbie Nobre D and Anne-Marie Hill A EA School of Physiotherapy, Institute of Health Research, The University of Notre Dame Australia, 19 Mouat Street, Fremantle, WA 6959, Australia.
B School of Medicine and Pharmacology, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia. Email: christopher.etherton-beer@uwa.edu.au
C School of Nursing and Midwifery, The University of Notre Dame Australia, 19 Mouat Street, Fremantle, WA 6959, Australia. Email: caroline.bulsara@nd.edu.au
D Brightwater Care Group, Level 3, 355 Scarborough Beach Road, Osborne Park, WA 6017, Australia. Email: debbie.nobre@brightwatergroup.com
E School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA 6845, Australia. Email: anne-marie.hill@curtin.edu.au
F Corresponding author. Email: jacqui.francis-coad@nd.edu.au
Australian Health Review 41(1) 13-18 https://doi.org/10.1071/AH15189
Submitted: 12 October 2015 Accepted: 1 February 2016 Published: 17 March 2016
Abstract
Objective This study evaluates whether a community of practice (CoP) could conduct a falls prevention clinical audit and identify gaps in falls prevention practice requiring action.
Methods Cross-sectional falls prevention clinical audits were conducted in 13 residential aged care (RAC) sites of a not-for-profit organisation providing care to a total of 779 residents. The audits were led by an operationalised CoP assisted by site clinical staff. A CoP is a group of people with a shared interest who get together to innovate for change. The CoP was made up of self-nominated staff representing all RAC sites and comprised of staff from various disciplines with a shared interest in falls prevention.
Results All 13 (100%) sites completed the audit. CoP conduct of the audit met identified criteria for an effective clinical audit. The priorities for improvement were identified as increasing the proportion of residents receiving vitamin D supplementation (mean 41.5%, s.d. 23.7) and development of mandatory falls prevention education for staff and a falls prevention policy, as neither was in place at any site. CoP actions undertaken included a letter to visiting GPs requesting support for vitamin D prescription, surveys of care staff and residents to inform falls education development, defining falls and writing a falls prevention policy.
Conclusion A CoP was able to effectively conduct an evidence-based falls prevention activity audit and identify gaps in practice. CoP members were well positioned, as site staff, to overcome barriers and facilitate action in falls prevention practice.
What is known about the topic? Audit and feedback is an effective way of measuring clinical quality and safety. CoPs have been established in healthcare using workplace staff to address clinical problems but little is known about their ability to audit and influence practice change.
What does this paper add? This study contributes to the body of knowledge on CoPs in healthcare by evaluating the performance of one in the domain of falls prevention audit action.
What are the implications for practitioners? A CoP is an effective model to engage staff in the clinical audit process. Clinical audits can raise staff awareness of gaps in practice and motivate staff to plan and action change as recommended in best practice guidelines.
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