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Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial
Falls are the most frequent adverse events that are reported in hospitals. We examined the effectiveness of individualised falls-prevention education for patients, supported by training and feedback for staff, delivered as a ward-level programme.
Eight rehabilitation units in general hospitals in Australia participated in this stepped-wedge, cluster-randomised study, undertaken during a 50 week period. Units were randomly assigned to intervention or control groups by use of computer-generated, random allocation sequences. We included patients admitted to the unit during the study with a Mini-Mental State Examination (MMSE) score of more than 23/30 to receive individualised education that was based on principles of changes in health behaviour from a trained health professional, in addition to usual care. We provided information about patients' goals, feedback about the ward environment, and perceived barriers to engagement in falls-prevention strategies to staff who were trained to support the uptake of strategies by patients. The coprimary outcome measures were patient rate of falls per 1000 patient-days and the proportion of patients who were fallers. All analyses were by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials registry, number ACTRN12612000877886).
Between Jan 13, and Dec 27, 2013, 3606 patients were admitted to the eight units (n=1983 control period; n=1623 intervention period). There were fewer falls (n=196, 7·80/1000 patient-days vs n=380, 13·78/1000 patient-days, adjusted rate ratio 0·60 [robust 95% CI 0·42–0·94], p=0·003), injurious falls (n=66, 2·63/1000 patient-days vs 131, 4·75/1000 patient-days, 0·65 [robust 95% CI 0·42–0·88], p=0·006), and fallers (n=136 [8·38%] vs n=248 [12·51%] adjusted odds ratio 0·55 [robust 95% CI 0·38 to 0·81], p=0·003) in the intervention compared with the control group. There was no significant difference in length of stay (intervention median 11 days [IQR 7–19], control 10 days [6–18]).
Individualised patient education programmes combined with training and feedback to staff added to usual care reduces the rates of falls and injurious falls in older patients in rehabilitation hospital-units.
State Health Research Advisory Council, Department of Health, Government of Western Australia.
Journal Article
Building global education with a local perspective : an introduction to glocal higher education
\"Glocal\" education melds the economic advantages of globalizing higher education with the benefits of incorporating local perspectives. This book explores glocal education's rationale; social, cultural, and economic foundations; key concepts; and implementation.
eBook
Change leadership in higher education : a practical guide to academic transformation
Initiate innovation and get things done with a guide to the process of academic change
Change Leadership in Higher Education is a call to action, urging administrators in higher education to get proactive about change. The author applies positive and creative leadership principles to the issue of leading change in higher education, providing a much-needed blueprint for changing the way change happens, and how the system reacts. Readers will examine four different models of change and look at change itself through ten different analytical lenses to highlight the areas where the current approach could be beneficially altered. The book accounts for the nuances in higher education culture and environment, and helps administrators see that change is natural and valuable, and can be addressed in creative and innovative ways.
The traditional model of education has been disrupted by MOOCs, faculty unions, online instruction, helicopter parents, and much more, leaving academic leaders accustomed to managing change. Leading change, however, is unfamiliar territory. This book is a guide to being proactive about change in a way that ensures a healthy future for the institution, complete with models and tools that help lead the way. Readers will:
* Learn to lead change instead of simply \"managing\" it
* Examine different models of change, and redefine existing approaches
* Discover a blueprint for changing the process of change
* Analyze academic change through different lenses to gain a wider perspective
Leading change involves some challenges, but this useful guide is a strong conceptual and pragmatic resource for forecasting those challenges, and going in prepared. Administrators and faculty no longer satisfied with the status quo can look to Change Leadership in Higher Education for real, actionable guidance on getting change accomplished.
eBook
Only Leave a Trace
“Make yourself big when you enter a room, when you meet a bear in the woods. Make yourself big. Meet the eyes.” Roger Epp’s poetic meditations about the best, the hardest, the loneliest times of leading a small university campus through significant change are depicted in a series of elegant yet understated prose pieces, alongside images by his life partner, Rhonda Harder Epp. Taking a candid look at the many challenges such a position brings, Roger Epp humanizes, scrutinizes, and upholds the integrity of academic administrative work. Only Leave a Trace will resonate with those who work in universities, hold leadership roles in them, or care about the connections between higher education, students, and place.
eBook
Building global education with a local perspective : an introduction to glocal higher education
\"Building Global Education with a Local Perspective introduces the concepts, theories, and practices associated with glocal higher education, based on an old idea \"think globally, act locally\", and \"think locally, act globally\". Jean Francois' outline of glocal higher education makes propositions and suggests frameworks that can serve as alternative to the limitations of the imperialist ambitions of global education. Using templates, case studies, illustrations, and activities, Jean Francois challenges the critical thinking of scholars and policy makers, and suggest original strategies to plan and implement programs, projects, and activities in international, comparative, and global education\"-- Provided by publisher.
Book
The Business of Innovating Online
The Business of Innovating Online responds to a critical need for concrete narratives of innovation success that can serve as a foundation for administrators and leaders who are in need of practical guidance as they scale and grow their online learning organizations.
Through specific examples and practical suggestions from experienced e-learning leaders, readers will be introduced to concrete strategies for how to create a climate of creativity and innovation that can lead to more successful and scalable online programs and initiatives. The Business of Innovating Online demystifies the relationship between business, creativity, and innovation by describing the logistics required to create an agile online education enterprise. Topics discussed will include:
Defining innovation and creativity for online education and e-learning
Knowing when and how to innovate
Creating a culture of innovation
Effectively leading innovation
Collaborative innovation
Making innovation stick and transitioning innovative strategies into day-to-day practice
Assuring quality in the midst of innovation
Staffing structures/administrative stability to support creativity and innovation
The Business of Innovating Online provides both novice and experienced online education administrators with a comprehensive overview of a range of online innovations, how they came to be created, the components that led to their success, and concrete steps that they can take to create a more innovative culture for their own e-learning organization.
eBook