INTRODUCTION
Over years, many nursing homes have been victims of the fall incidence, making the geriatric long term-care care population at risk. Falls among nursing facilities has gone overboard, as they take place frequently, and repeatedly. For example, nearly 1800 older people staying in nursing homes die annually from fall and other fall related problems, while those who survive these falls, normally incur body fractures such as hip and head, resulting to reduced life quality and permanent disability. This issue has turned out to be a big problem to many nursing homes, thus the need to come up with real time solutions. While on the other hand, critics might be quick to say that some falls will take place in nursing homes, despite of the excellence and efficiency of the care. Nonetheless, it is still crucial to implement process of improving the incidence of fall in nursing homes.
The implementation of a fall prevention and improvement program is essential for facilitating resident safety. Ideally, organized assessment of the members’ risk of fall and coming up with programs to prevent these falls, can alleviate the cases of falls in geriatric care homes. However, there are a number of things which will be involved on the verge of process improvement and implementation.
The process of improving or reducing the fall occurrences in nursing homes requires a number of resources such as; time, money, as well as joint efforts from the facility staff. When it comes to change, most weight will lie on the financial part, as the whole program requires professional who will spear-head the process improvement. Moreover, it is obvious that for an excellent job to happen there must be some amount of motivation, in terms of monetary forms. Because of this reason, the process will have to inflate the facility overall expenditure on human resource. This will be due to purchase of more sophisticated and reliable equipment at the nursing home, where it will reduce incidences of falls. For example, resident members sometime fall from their beds or trip on the floor. This will force the facility to buy high quality furniture like beds and chairs that will reduce unnecessary falls. Moreover, nursing homes will have to increase their employees or resident attendants who will take care of the elderly, and reduce frequent movements which might cause falls. (Perron, 2008)
Research studies claim that a change tool is crucial to initiate a new program; however, the change must be carried out as a facility or team wide effort. The whole process requires staff and administrative support for successful maintenance and implementation of the program.
The cost analysis of implementation
The expense related with implementing the fall prevention and improvement program involves various costs such as; staff training, risk management, in form of monitoring and documentation, equipment, and additional supplies. Conversely, since fall and fall associated injuries among elderly people are linked with substantial financial costs, which in most cases are typically much more that the expense to initiate evidence-based fall improvement program, the advantages emanating from the implementation of such an initiative supersedes the crucial need to implement fall improvement program in nursing homes. In simple terms the cost that will be used to implement process improvement program or change project will be lesser than the benefits accrued from the implementation, thus the inevitable need to launch the project. (Jcr, 2008)
Here is the cost analysis of potential training, staffing, and equipment.
Staffing; the training of staff will include employing of trained personnel who will be expected to improve the skills of the staff. Here is a rough estimate of what it will cost.
Hiring of a training workshop room (the organization can use the available rooms in the nursing home)
Payment of the training personnel (wages) - $100 per day.
Purchase of training equipment and tools (such as marker pen, whiteboard, and other essential practical tools) - $ 200
Other niceties such as; drinks and snacks - $ 10 per head
TOTAL = $500 (this should be a rough estimate of the training costs, however an organization can increase it depending on the number of their staff)
Staffing; this involves the process of hiring right employees for the appropriate job position. Ideally, a larger part of this cost will go to the development of an HRM department in the nursing home. Here are some of the basic expenses
Overall Salaries and wages of the HR managers- $ 1000 per month
Other costs for workers assessment program before they are placed at different job position - $ 500
TOTAL = $1500
Equipment; This include various tools that can be used in the nursing home, for instance;
Beds - $ 50 per bed
Durable chairs and relaxing hammocks- $ 50 per item
Non-slippery floor - $ 500
Special Walking sticks - $ 20 each
The total cost will be calculated based on the number of residents in the nursing home.
The basic question regarding cost-benefit analysis is; do the economic benefits of offering this specific service of change project outweigh the costs? Is it worth carrying it out at all? In this context, the nursing home will spend a total of;
Training; $500
Staffing $1500
Equipment $ 2000
Total; $4000
This total cost will be assessed against long term benefits. This will be calculated after carrying out organizational financial analysis such as; balance sheets and profit and loss accounts.
The idea behind this cost analysis is simple; if all outcomes and inputs of a proposed alternative can be narrowed down to a common unit of impact, where they can be calculated and compared. The benefits will be determined by determining a quantifiable dollar benefit for a given period, in which it accrued, and find out the present value calculation.
Net present value; this will be determined by subtracting the project total cost from the present value of benefits.
Cost- Benefit Ratio; Determine the cost – benefit by dividing the total present value of benefits by the project cost.
Moreover, on the other hand, the returns on investment of the organization will be immense, in the long run, for instance; the primary desired outcome for the fall improvement and reduction projects is to alleviate falls among the resident members. Desirable patient outcomes will include various things such as; members increased knowledge about falls; increased mobility, strength, and balance; increased confidence in abilities; reduced severity of fall associated injuries; and increased independence with the use of exercise and adaptive devices are required. Moreover, the organization will make huge returns, as a result of improved system, and this will cause more people to enroll into the facility. Some of health care funding can also be channeled or injected back to the change project; however, there should be a special committee which will overlook the amount of funds to use from for reimbursements. (Chernoff, 2013)
CONCLUSION
Protecting elderly people from falls and other fall-related injuries needs shared responsibility among health care practitioners, risk managers, and administrators. Fall prevention is an essential and timely matter that requires to be addressed by all responsible healthcare providers, and most particularly in the care of the elderly people in nursing home centers. Using standardized and appropriate guidelines for fall prevention is very important to the implementation of a successful improvement and prevention project. Moreover, implementation of this program or project will have positive implications for the nursing homes. Furthermore, the initiative will boost the nursing homes employees and increase their confidence in alleviating falls. An effective fall reduction project can decrease falls in nursing homes, in return enhancing cost-effectiveness associated with prevention of falls and mortality issues.
References
Chernoff, R. (2013). Geriatric Nutrition. Massachusetts, U.S.A.: Jones & Bartlett Publishers
Jcr. (2008). Reducing the Risk of Patient Harm Resulting from Falls: Toolkit for Implementing National Patient Safety Goal 9. Illinois, U.S.A.: Joint Commission Resources, Inc
Perron, L. (2008).Determining Predictors of Nursing Home Admission and Sub-populations of Skilled Nursing Facility Residents Using the Medicare Current Beneficiary Survey (MCBS). Michigan, U.S.A.: ProQuest publishers.
