Safe Steps
A digital falls risk assessment tool created for our ageing population. Keeping people safe, step by step.
The Challenge
For many years, Wirral’s older population maintained their position as ‘top of the league for the number of falls’. This brought a whole range of costs and consequences. For 11.8 million residents aged 65+ across the UK, falls remain their leading cause of death and disability. In some areas of the country, it is thought that as many as 6 people over the age of 65 suffer a fall every minute.1
Falls and fall-related injuries in people aged 65+ are on the rise. With this comes many devastating consequences that can lead to long-term physical and mental health issues.
A fall can shatter a person’s sense of independence and autonomy, sparking periods of isolation and hampering confidence. A once confident and glowing personality is shattered, leading older people to spirals of anxiety, embarrassment and depression. It sparks unnecessary trauma and chronic fear: ‘Am I going to fall over again? What’s going to happen if I do?’
We knew each of these falls was preventable. We knew it was time to listen.
Listening
We knew we had to start by listening to what caregivers and organisations wanted and needed. We knew that the Wirral’s elderly population, alongside their caregivers, were faced with a lack of resources. We realised we needed to eliminate the barriers to risk management, prevention of falls and aftercare on the borough. We worked alongside Wirral Independent Services, who commissioned us to develop a resource that would standardise assessments and responses connected to fall-related injuries.
Our conversations revealed that many professionals are frustrated by the lack of uniformity in procedure. They recognised that, without a holistic approach to fall prevention in the borough, the number of injuries would no doubt continue to soar.
Staff and caregivers told us how proud and committed they are to their work. Many staff members had already established strong, positive relationships over a number of years. From our conversations, it quickly became evident just how deeply invested these care workers are in the individuals whom they assist.
When a fall took place, they frequently witnessed a dramatic change of character where people became markedly anxious, cautious and withdrawn. It truly is a ‘wicked issue’, not only for those working within the care profession, but for the individuals too. It was time to think.
We’ve got 106 care homes on the Wirral and there are a lot of fragmented approaches in falls screening. We felt that an app would standardise the approach across the homes.
Thinking
Having reflected upon these consultations, we met with a range of stakeholders to exchange ideas and begin to co-create. Listening to our stakeholders, we learned that an easy to access digital record was really important alongside diminished paperwork. Their preference reinforced our knowledge that workers wanted to access information on individuals swiftly and efficiently.
We applied everything we had learned in our conversations to refine our plan. Safe Steps was going to give care providers access to every screening that had already taken place, giving care workers the opportunity to revise essential information. Safe Steps would be based on structures akin to the Traffic Light System in care, which would track where and when assessments were due to take place.
The tool would also identify who hasn’t received routine assessment - an issue frequently encountered by carers who, for many years, had relied on the accuracy of paperwork. In addition to this, we wanted to establish a function where reports could be created or generated based around each resident, allowing for workers to access individual repositories of information showing which risk strategies work best for each resident. This would allow for users to clearly identify projected risk for each person.
With these factors in mind, we created Safe Steps’ first wireframe and prototype.
We are always keen to get involved with projects that will help the health and care of our residents. That’s the most important thing for us. Whether it’s for falls prevention or for anything else that is going to help the residents, we most definitely want to be involved.
It flags up any problems, it helps us to manage those problems. It's great, I think every home should be using it.
Doing
Our findings from the previous stages gave us a lot of information to process and experiment with, leading us to rapidly generate an app that was ready to pilot among a number of Wirral care homes. The purpose was to test and see if what we had built was successful, and what avenues for improvement we could explore for Safe Steps.
Pilot testers within each home were provided with the software needed to test the Safe Steps app. Testers were actively encouraged to record and monitor data relevant to each risk assessment factor which was relevant to fall prevention strategy.
Testers reported back on the aspects they enjoyed whilst navigating the app. Some reports included stories on how the tool had generated a positive impact between caregivers and individuals; one tester remarked that the presence of new digital technology during visits prompted questions and curiosity as to their functionality.
Safe Steps is already helping gel communication between numerous care professionals, allowing them to communicate effectively amongst themselves and exchange good practice.