“Escaping” your typical SNF Falls Training: A unique approach to building a team-based approach to manage falls for residents

This blog originally appeared in McKnight’s Long Term Care News as a guest column. Read the original article.

Training for falls management in Skilled Nursing Facilities (SNFs), or most commonly known as nursing homes, can follow a formulaic regimen. Education typically includes residents being at a risk for falls due to a variety of conditions such as physical recovery from an injury, medications, vision issues or other factors. Typically, employees utilize a computer training program for routine falls education. While this is the typical educational format, it does not promote engagement between the presenter and learner.

However, Beth Divelbiss, Director of Clinical Outcomes, Data and Education for Kissito Healthcare, saw this as an opportunity to build a falls training that had Kissito leadership teams work together and look at all aspects of a residents’ life. The goal was to have an engaging all-team approach to know the resident to help identify potential circumstances that could increase the odds of the resident experiencing a fall.

The answer: an escape room. Yes, the popular and growing experience of escape rooms for SNF training. One of the first escape room concepts was in 2003 at a gaming convention in Indianapolis, Indiana. The True Dungeon escape room featured many of the same ideas that today’s escape rooms have: a live-action game where players must cooperate to solve mental and physical puzzles to accomplish a goal. As of 2019, there was an estimated to be more than 50,000 escape rooms.

Recently, the Chief Administrative Officers and Directors of Nursing from each Kissito Healthcare center were at the Roanoke, VA based headquarters for a quarterly meeting. Each leadership team had a break-away session to go into a close conference room that had been transformed into an escape room.

Upon entering, the leadership team saw Julie Campbell, a Kissito Healthcare Home Office employee, dressed as a resident sitting in a chair in the center of the room. Prior to entering the room, some information on Julie was shared with the attendees—e.g., she was a new admit to the facility, pleasantly confused, and in the early stages of dementia. Around the ‘resident’ there were four stations, with two ‘rooms’ per station.

Each room involved a resident story, and a key to understanding the residents fall history was revealed if attendees could figure out the puzzle. For example, to obtain the residents current medications attendees had to open the resident’s medication puzzle box…which took teamwork and thinking about things from a different perspective. Throughout the experience, Julie would interact with attendees, frequently giving them hints to the puzzles within the rooms, but attendees had to pay attention to that interaction to catch small things.

For instance, one station had Julie’s vision status hidden within a word puzzle, that required a mirror to read clearly understand. The mirror was hidden under the tablecloth of the room and when attendees got to that station Julie would ask, “has anyone seen my mirror? I can’t seem to find it.”
“This approach presented a different, more creative and engaging way to teach a common topic,” said Divelbiss. “To teach teamwork as part of the falls management process in the building.”

The teams had to go to each room and work together as a team to figure out the answer to that stations riddle and figure out the physical challenge before moving to the next room.

“The Escape Room for Falls training was very interactive. In typical falls training we talk about things that can increase your risk of falls and interventions for those individuals that are at a higher risk for falls. The Escape Room was an excellent way to make the training engaging,” said Maple Grove Nursing & Rehab Chief Administrative Officer Amanda Dowell. “Not only was it a game, but it was a way to think outside the box. Instead of talking about different scenarios we were put into the scenario. It was a person-centered training to addressing falls that we can take back to the centers and apply it to our residents.”

The average time to complete the training was 20-22 minutes.

“The goal was to provide a new and engaging way to teach a topic that most seasoned nurses truly know the answers. Falls management is a TEAM approach—the Escape Room gave attendees a fun, interactive way to learn about falls and risks associated, but in a way that was fun and memorable” Divelbiss said. “Now when they discuss falls in morning meeting, they remember the Escape Room—the team approach…and hopefully apply that paradigm to the daily care of our residents.”

Author: Brandon S. Totten
Digital Media Coordinator, Kissito Healthcare

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