Evaluation For Hip Fracture Prevention Program

The assignment task is to design an appropriate evaluation for the Preparation and Implementation Project outlined above and ongoing monitoring in the first two years of the Hip Fracture Prevention Program. Students can discuss the assignments with other fellow students, however students should write up the assignment individually and independently. 

Purpose of the evaluation of implementation project

The main aim of this assessment is to demonstrate the program planning and evaluation with the consideration of public health issues. In relation to the program planning, Hip Fracture prevention plan is designed to control the fall prevention program in order to reduce the high morality, morbidity and higher cost attached due to the falling of people in residential aged care centre. The fall resulted into the various challenges for the aged people which directly influence the carer to provide significant facility for improving the health problem so the evaluation program is developed. The program is evaluated in two different phases such as preparation and implementation project for 12 months and second one is ongoing phase onwards from 13^th month. Along with this, the report also includes the strategies and activities with the aligned budget for aged care people in order to protect from high- risks. With relation to this, process evaluation and impact evaluation are also focused with the rationale of approach of selecting the evaluation method. On the other hand, potential risks and issues are also determined along with the monitoring of hip prevention program. 

The main purpose of evaluation of this program is to determine the relevancy or actions that are appropriate or need to be improved with the successful development of public health management program. The project is aimed to prepare and implement the health program through which the rate of falling in residential aged care center can be improved. From the 10 Jurassic residential care report, it is determined that the rate of falling is increasing as 1000 people fall in the total of 500 high care places. It is also assessed that the aged people fall and injury occurred and many people might die after the 12 months of falling. The major problems occurred as fractures in the different parts of body (CDC, 2015).

The hip fracture has become a significant health problem as it is influencing the 1.6 million people annually. On the other hand, the hip fracture incidence is also projected to increase by 3.9 million by the year 2050. In context to this, the hip fracture is resulted into the mortality and morbidity. At the same time, the hip fracture is also resulted into the increased cost for the rehabilitation of fracture for the aged people. It is also evaluated that the people are also dying because of the hip fracture from long time. Due to the falling, disease occurred such as necks of femur, colles fracture and head injury but it is also determined that the old age people suffered from the hip fracture which is becoming a serious health problem for the individual and care societies (Cosman, et al., 2014).

The objectives of this hip fracture prevention program are as

To reduce the falling incidence by 50$ within the year

To reduce fractured necks of femur by 50% within one year

To reduce health care costs for falls by $500,000 within one year                                                                                   

In order to reduce the hip fracture prevention program for the 10 residential facilities in the Jurassic aged care residents, the program can be developed through adopting the fall risk assessment method in which the representative in the 10 residents will report the incident occurrence so that the reason behind the incidence can be measured that will work for taking the protective actions (Bjerk, et. al, 2017). At the same time, the monitoring can be done in order to gather the data from residential care. The monitoring system can also be implemented in the 10 residential cares for improving the concurrent situation.

Development of strategies for reducing hip fracture prevention program

In order to evaluate the planning and implementation of hip fracture prevention over the 500 high care plan with the incorporating of process implementation and impact implementation methods. The evaluation strategy is needed to be implemented with the careful consideration so that the concurrent ways of hip fracture prevention program can be improved and with the identification of strengths and weaknesses of strategies that have been adopted to help the residential cares for controlling the falling incidents in old age people (Hsiao, 2016).

The process evaluation tactic can be implemented for the determination of strategy or program to evaluate whether the strategies were adopted as per the planned or the results have been produced as it were expected. In relation to the falling incidents or preventing the hip fracture in old age people, the process evaluation is designed as follows       

Strategies	Key Activities/components to be included in process evaluation	Indicators for measurement	Methods for measurement (How will you collect the data)	When will the information be collected?
To implement the fall risk assessment method:	In order to implement the fall risk assessment method, a systematic process has been implemented so that the relevant data about the falling and hip fracture can be measured in effective manner. Along with this, the register is also maintained so that the falling occurrence can be recorded (Pilla, 2016).	To record the number of falling in fall for the old age people in the 10 residential cares.	The data about the falling occurrence will be collected through direct respondents from the residential care for which a respondent has been appointed to record the data.	The information related to the falling challenge will be collected for the 3 months.
Implementation of monitoring system	With regard to the monitoring system of fall prevention, reporting will be made day by day for 3 months to reach at result.	The registrar will make the entries over day to day so the overall falling can be measured in efficient manner.	The data will be collected from the 10 residential cares	The information will be reported on same day when the incident has occurred.
Training to caring staff at the residential home for old age people	In order to provide the training to the care staff, a trainer will be hired for delivering the training to its staff. The training programme will be provided for 15 days so that the rate of falling and hip prevention fracture can be reduced.	In context to this, the improvement will be recorded over the reduced rate of falling and the fracture incidents. If the rate of falling has reduced that it can be measured that the training strategy is effective to implement and the results are obtained in positive manner than the results can be assessed.	The data will be collected from the people who have got training from the appointed person. The data about the impact of training will be collected so that the results can be assessed and the action can be taken for improving the conditions of falling rate.	The data will be collected after the training provided to the care staff at 10 residents.
To provide the regular remedial physiotherapy to the old age people	The representative over the residential care, will engage into delivering the remedial physiotherapy with the daily practices for 1 hour to old people	The major indicators will be included as improvement in old age people, falling rate decrement, positive impact on health to reduce the other health disease in body (Cifu, et. al, 2018)	In order to measure the data or information, daily check up for the health of old people will be carried out and the progress will also be reported for taking the decisions about the data. It will also be observed that how much people are taking seriously and its impact for bringing the improvement in body.	The information related to this, will be collected in the starting of remedial physiotherapy so that the performance can be reported in quantities measure.
Environmental risk factor strategy for implementation of successful planning	The environmental factors which can influence the health will also be considered for old people to provide them better environment.	Impact of environment aspects can be measured for short run of time to identify the impact	In order to collect the rate of incidence occurrence will be assessed over the environmental factor considering.	The information will be collected for the 3 months of implementing the program evaluation.

The impact evaluation is another approach of assessing the results of information which are employed to identify the results of program as it is determined that the designed objectives have been achieved or not (Stanhope, et. al, 2016). It is supportive to review the effectiveness of planning and implementation program for health problem management.           

Objectives	Indicators of achievements / Success indicators	Methods for Measurements including details of data collection	When should data collection and analysis take place?
To reduce the falling rate occurrence	The results from the 10 residents will be assessed. How the people are experiencing the fall prevention program as people are not intervene than it might not be easy to obtain the positive results. Along with this, the qualitative data will be measured rather than the qualitative data as the numerical results might be more realistic than the qualitative and results can be drawn (Taing and McKay, 2017)	The qualitative data will be collected from the 500 residential cares in proper reporting manner. In addition to this, for primary information, 200 peoples can be chosen to predict and obtain the results. Direct observation will be determined to collect the information with the support of residential carer representative.	The data should be collected while the program has been fully implemented so that the accurate results can be obtained in reliable manner. At the same time, the data should be planned as per the result purpose so that the decisions can be taken.
The health disease identification	To test the health of old age people for short time. Along with this, rate of falling in old age people should be measured with the support of peoples. Controlling of health issues.	The health check –up activities will be measured day by day so that the appropriate data can be collected. Reduction in the health disease can also be measured as the data collection (Colón-Emeric et. Al, 2017).	This type of data should be collected through the monitoring process of recording the information about the health of old age people.

The internal and external validity for the strategies is also valuable for the public health to manage the different mechanism of people health with less effort. In order to control the internal control of validity, the cause and effect relationship can be implemented such as the relationship in between the planning and implementation program and its impact on falling control that might be supportive to reduce the hip fracture in the old age people (Issel and Wells, 2017). In order to draw the results from the internal validation, the sample should be selected in appropriate manner. On the other hand, external validity is concerned to the effectiveness of data or information from which the results can be obtained in positive manner.

Risks usually comprise of probability of something which can go wrong and its adverse consequences. A general idea can be guessed for the potential risk. On the other hand, an issue seems to be less predictable and can occur without any warning. For instance, inability to find the right and qualified staff is a potential risk. If in case, the staff member undergoes any illness or accident he will be required to take leave which will be unplanned. This type of incidence which comes without any warning and can have adverse consequences is known as an issue (Reason, 2016). If the risks are not identified in the beginning of the project then it may turn into issues in the later stages. Here are some risks identified based on the evaluation of processes and impact:

Human risk: The strategies designed for implementing the methods of fall risks assessment will definitely require human assistance in it. There may be a risk of loss of any particular individual in the project due to injury or illness which can adversely impact the operations of the project (Hillson, 2017).

Operational risk: It refers to the risks associated with disruption of operations and purchases or failure. The project member may fail to introduce fall monitoring system in ten different facilities within the time allotted for this process.

Procedural risk: This type of risk is associated with accountability failures, internal system failure, and failure of control. The project members may not be able to take responsibility of their work such as daily work and effort for reduction in the physical factors of risks which will eventually lead to delay in the target of the project. The team members of the project may not be able to co-ordinate properly which will lose control on fulfilling the objectives of the project (Woodcock, 2017).

Project risk: This type of risk is associated with the over budget of the project, key tasks taking too long to get accomplished, and quality issue. The project has different budgets for policies to reducing the fall incidences and fractured femur or necks. If the objectives of the tasks are taking too long to get accomplished then the budget allocated for fulfillment of each objective will cross its limit and the project will become over budgeted. Apart from this, there may be issues with the quality of the services because project lacks zeal and enthusiasm when it not completed on time which leads to lacking in quality (Fayol, 2016).

The risks, issues, problems, inconsistencies, gaps, and conflicts are required to be recorded when they occur. In order to record or address them, issues logs can be created. It is a tool which can be used for communicating and reporting whatever is happening in the project (Bell, 2014). An issues log is beneficial in number of ways. It enables the projects managers to plan a reliable and safe method for raising issues of the team. It assign and track responsibility of the people which for each specific issue. It aids in analyzing and prioritizing issues with more ease. In addition to this, it enables the project managers to record the resolution of the issues which can be used in future references and project learning. The health and status of the project can also be monitored in this way.

The issue log may contain the following information:

Type of risk or issue: It defines the risk or issue category which will be encountered. This phenomenon will be helpful in tracking the relevant issues assigning the right kind of people for resolving it. There are certain kinds of risk or issues which will be associated with this project and shall be addressed such as:

• Technical risk which is related to any problem in the project which is technical in nature such as improving working of machinery or equipment for setting the fractured body parts due to fall (Wong, et al., 2018).
• Process of the business which is related to the design of the project.
• Management of change which is related to changes in the living of aged people and environment in which they live.
• Issue with the resources which is related to the problems associated with material, equipment, and people involved in the project.

Identifier: The person who discovered the risk or issue shall be recorded.

Timing: The date and time of the issue shall be addressed.

Description: The details of the issues and its potential impact on the issue shall be addressed. For instance, if there is any absence of a project member then which part of the project has been affected and what have been left unresolved.

 Priority: The priority of the risk or issue shall be set according to its value. For instance, if there is any critical risk identified such as unavailability of right staff for checkup and replacement of the hip protector then it can be set on high priority. Likewise, the issues whose impacts are noticeable but cannot restrict the project to proceed can be set on medium priority such as provision of regular physiotherapy remedies to the residents (Williams, 2016). The risk or issues by which the critical path activities of the does not get affected are known can be set on lowest priority such as reduction in the cost of health care.

Assignment: It is significant to determine a person who can be held responsible for issue resolving. The person clear will be responsible for tracking the issue and dealing with it according to its level of priority.

Status: It is also significant to track the resolution progress with clear identification of the overall status of the risk. For instance, if the issue has been identified but the action is still pending against it then it can be addressed as open. If the possible solutions have been identified then it can be addressed as investigating. If the resolution for the issue is still under process then it can be addressed as implementing (Glaser and Strauss, 2017). If the issue is raised to senior level and is pending for the approval of the solution then it is addressed as escalated. If the issue has been fixed totally then it can be considered as resolved.

It is the process of detection of risk issues and compliance associated with the operations of the project. There are people, systems, and processes which work together for supporting the project efficiently and effectively. The focus of the ongoing monitoring is on the following:

Accountability

The director of the project for prevention of fall from residents has the responsibility to ensure that the project is operating effectively. It is the duty of the director to make sure that the managing staff is capable enough of fulfilling the responsibility of monitoring (Kerzner, 2018). It is also significant for the managers to ensure that training is provided to the staff members for performing the operations in the care plan.

Follow up

A follow-up is basically a check to determine if the corrective measures are being applied as suggested by the managers. It also determines whether the corrective actions were successful or not.

Self assessment

The data of the care project is collected, aggregated, and analyzed throughout the year for the project and the same data is used for conducting the self-assessment annually. Ideal time is created by the self-assessment for examining the yearly data with much ease (Cooper, et al., 2018). The data sets of different months are helpful in uncovering the trends or patterns on the basis of collected data.

Quantitative and qualitative indicators:

Both the quantitative and qualitative indicators can be used by the project managers to make sure that the ongoing monitoring is going up to the mark. The quantitative indicator will aid in determining to what extend the number of the falls have been reduced. It will also make sure that whether the project has been able to fulfill its targets and objectives with the available budget. For instance, the annual budget for staff training was $30000. The quantitative indicator will reflect if the training has been provided under the suggested budget or not (Wildavsky, 2017).

The qualitative indicator will help the mangers to analyze if they have been able to provide the care services to the fall patients in an effective manner or not. This will done by using questionnaire or focus group technique to address the comment of the patients who received the care under this project. The negative comments can be useful to enhance the process and procedures of the care.

Program-based and Population-based:

The information based on program is crucial for evaluating the program performance and output received such as number of fall patients administered in a month. The source of data for program-based indicators is usually from information of routine health (Grembowski, 2015). On the other hand, the population-based indicator is crucial in evaluating the number of overall impact of the project on the entire population. The project managers will be able to evaluate the number overall reduction in the falls by installing monitoring system of falls in different facilities.     

Conclusion 

On the basis of above analysis, it can be concluded that the planning and implementation program is evaluated over the set objectives as reducing the number of falling in the residential people. In addition to this, it can also be concluded that the process evaluation and impact evaluation are also valuable to identify the relevancy of data and the needs of improvement can also be assessed to gaining the positive results. With respect to this, over the evaluation program, risk and challenges can be mitigated in efficient manner. 

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