Implementing risk assessment tools: A success story from a Finnish discharge unit

This article is based on a presentation given at Medanets User Days 2025 by Anna-Kaisa Rantala. Rantala is the service manager of a Lauttaranta discharge unit in the wellbeing services county of Kymenlaakso in South-East Finland.

The Lauttaranta discharge unit provides short-term, 24-hour inpatient care for clients who come to the unit from specialised care or after a stay in a primary care ward. The unit has 72 ward beds and 4 crisis beds, with a staffing level of 0.78. The Medanets app is used on the unit’s smartphones to improve information flow and risk management.  This is their story of successfully implementing risk assessment tools.

Initial challenges and solutions for successful implementation

The staff had been trained to use the Medanets app some time ago, but the use of the app had been limited. In late 2023, the unit introduced a policy to complete Falls Risk Assessments and Mini Nutritional Assessments for all clients upon admission. The unit decided to start using the Medanets app, which was already installed on the unit’s devices, as a tool for completing these assessments.

However, time had passed since the previous Medanets training sessions, and things had been forgotten. Not everyone had the necessary credentials to use the app, and some malfunctions caused issues with data transfer. Action was needed. New Medanets trainings were organised to enhance compliance with the new policy. The unit also organised team meetings to help staff create the necessary credentials and to emphasize the importance of completing the assessments using Medanets. The organisation’s IT service coordinator, in turn, provided assistance and advice to resolve any problems that occurred.

Embracing change: shifting mindsets for success

Success required a shift in mindset and a willingness to learn new things, moving away from old habits and embracing new ones. Peer support played a crucial role in the implementation: when a few users became enthusiastic, their positive attitude spread to others. The visible support of the frontline staff and concrete measures such as the kick-off and weekly meetings were also key to success.

The change was accelerated when the staff discovered that using Medanets made completing the assessments easier and the work faster. They found the app easy and useful to use. The positive experience motivated ongoing use of the app and fueled its further development.

Ongoing improvement and future objectives

Ongoing development requires tracking the number of new clients and completed risk aseessments, ensuring that all clients are assessed according to the policy. Therefore, Rantala actively monitors usage reports to stay informed on the situation.

Training will continue, and guidelines will be refined to improve risk management. It is important to establish clear protocols for responding to the results of the assessments.

The wellbeing services county has drawn up guidelines based on the assessment results, including:

• Individualised measures to prevent falls based on the FRAT result in social services
• Nutritional status assessment based on the MNA results.

The unit is currently working on better documenting the actions taken for each client and thus making the work more transparent.

The aim is to draw attention to increased risks early, before visible damage (e.g., pressure ulcers) occurs, to prevent more serious harm. It is also important to remember that not all elevated risks are externally visible. For example, malnutrition may not be immediately apparent.  A standardised risk assessment tool helps address even the invisible risks proactively.

Finally, Rantala emphasised the importance of addressing encountered challenges and celebrating positive outcomes.

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