Award-winning falls response initiative with the Raizer: SWAST Case Study
How the South Western Ambulance Service reduced response times and improved the quality of care for fallen patients
There are over 12 million over-65s living in the UK. And every minute, six of them will suffer a fall. According to the National Ambulance Service Clinical Quality Group, 40% of all ambulance call-outs in over-65s are due to falls.
This places a huge strain on the country’s ambulance services, and as such, it’s not uncommon for patients to wait hours for help. This is because non-injury falls are assigned to the lowest priority category for ambulance callouts, Category 4.
In May 2021, the average response time for Category 4 calls in the UK was 2 hours 32 minutes and 90% of calls were responded to in 5 hours and 33 minutes or under.
However, even if the fallen patient has not been immediately injured, we know that long lies (spending more than one hour on the floor) cause a range of complications including pressure sores, dehydration, hypothermia, pneumonia and acute kidney failure.
The South Western Ambulance Service NHS Trust (SWASFT) faces a particularly tough challenge when it comes to treating fallen patients, as the team serves the oldest comparative population in the UK.
In 2018, the Trust decided to trial a project which would seek to reduce response times and improve the quality of care for fallen patients. The project proved to be hugely successful, and even secured the Trust a win at the 2018 HSJ Awards, in the category of ‘Care of Older People’.
The project relied on the utilisation of three key assets: Community First Responders, Raizer Emergency Lifting Chairs and a decision-support tool.
Community First Responders
Community First Responders (CFRs) are volunteers who work with ambulance trusts to provide a fast response to patients in their own local communities. Historically, they have been tasked with attending ambulance calls that are classified as life-threatening and needing immediate intervention, such as a cardiac arrest, to give rapid and potentially life-saving first aid before the ambulance crews arrive.
However, the team at SWASFT saw an opportunity to expand the remit of their CFRs to help assess fallen patients and lift them off the floor in a timely way.
Raizer Emergency Lifting Chairs
In order to empower CFRs to lift fallen patients, SWASFT needed to kit them out with proper equipment.
The Raizer Emergency Lifting Chair is a mechanical lifting device that can be operated with little to no physical effort, by a single person. It comprises of a small number of colour-coded pieces and is easily assembled around the fallen person. The chair can then be raised, either via a battery-operated motor or a geared hand-crank, depending on the chosen model. The chair lifts the fallen person in a seated position, until they are in an optimum position to mobilise to their feet.
Decision support tool
All CFRs involved in the pilot project received thorough training, including access to a decision support tool specifically developed to assess the impact of a fall. The tool covers areas such as symptoms experienced at the time of the fall, history of previous falls, location of the fall and any trauma caused by the fall. The CFRs also take more general observations, such as blood pressure, and a medical history.
CFRs are supported by a remote clinician via phone, and have expert medical advice on-hand throughout.
Equipped with just 70 Raizer Chairs, in the first eight weeks of the project:
- 77% of incidents were managed by CFRs using the decision support tool and remote clinical support, without the need for an ambulance response
- there was a 12.5% decrease in response times
- there were no adverse or serious incidents
- 148 hours of operational time was saved for the ambulance trust- which freed up crews to attend the highest acuity patients
- the Trust achieved a £10,895.28 efficiency saving based on operational time saved – however, if this were to include the potential cost savings of admission avoidance to secondary care, the overall savings figure for the NHS could potentially have run into hundreds of thousands more.
Following the award-winning trial, SWASFT has embedded this approach as normal practice within the Trust, and to date have equipped nearly 150 eligible CFR teams in the South West.
There are approximately 40,000 CFRs operating in the UK. There is therefore a huge potential for ambulance trusts across the country to embrace this approach, and improve the quality of care for the thousands of patients who suffer a fall every year.
Speak to us about equipping your team with the Raizer
Here at Felgains, we work with care homes, domiciliary agencies and charitable organisations, as well as ambulance trusts and private individuals, to implement solutions that improve the quality of care in falls response.