Minimize your fall risk and prevent fall injuries with an active falls prevention program
Falls are a serious issue for hospitals and healthcare facilities. While elderly and frail patients are typically considered to be the most at risk, all staff need to be aware that any patient, regardless of age or fitness level, can have high fall risk factors due to their medical condition, prescribed medications, diagnostic testing, and the impact of surgery and other procedures, all of which can leave the patient weakened or confused and vulnerable to a fall.
In this article, we outline the main eight reasons why you need to implement a falls management program without delay to prevent fall injuries.
1. Falls are often avoidable yet occur frequently
The Joint Commission’s Sentinel Event database cites that there have been 465 falls resulting in injury since 2009. The majority of these falls took place in hospital. Shockingly, over 60% of those falls resulted in death.
What’s more, hospitals aren’t the only facilities at risk of serious falls. The ECRI Institute states that many also occur in other health care settings, such as long-term nursing or care homes, making falls a serious issue throughout the healthcare industry. Many of these falls could have been prevented had the facilities concerned instituted a falls management program.
Research has shown that there are a number of factors that have a demonstrable link to an increased risk of falls and should be addressed without delay. These have been identified as:
- Inadequate or poor risk assessment
- A breakdown in communications or poor communication processes
- Failure to adhere to existing protocols and safety best practice
- Poor staff training and supervision
- Inadequate staffing levels or skill set
- Poor physical environment
- An absence of strong leadership
An effective fall management program will take into account all of these issues, massively decreasing the risk of a patient falling.
2. Falls have a negative effect on a patient’s health
A patient who has suffered a serious fall faces the potential of a more difficult recovery. An injured patient will need further treatment to deal with the consequences of the fall, which may even necessitate a longer time in hospital than originally envisaged. Indeed, one study found that patients who experienced a fall resulting in injury had an average of an extra 6.3 days added to their hospital stay.
It isn’t just that a fall requires extra treatment for fall related injuries, either. A fall can have a serious detrimental impact on a patient’s overall physical and mental health, which can impede recovery from their initial health issue or even cause their general health to decline considerably.
3. Falls are expensive
The cost of falls for both patient and facility can be phenomenal. The average cost of a fall resulting in injury is approx. $14,000, using up time and resources that could have been more effectively placed elsewhere.
However, that’s not the only financial cost that you need to consider. If a patient falls during a stay at your facility, without a fall management program, you could be found negligent in your duty of care, making you responsible for the fall. Any associated legal costs will be exponentially higher.
In addition, in 2015, CMS announced that it was reducing Medicare payments to over 700 hospitals as part of the Hospital-Acquired Condition Reduction Program. This federal program is aimed at reducing the number of hospital-acquired medical conditions in a bid to improve patient safety and outcomes. A number of factors determined whether a hospital would face penalties, but one of the biggest categories was the number of patient falls in each facility.
4. Falls have a negative impact on your reputation
Falls can have a severe financial penalty attached to them, but there are other, intangible costs involved. Falls can do serious damage to your facility’s reputation, damage that can take years to undo. Negative media coverage surrounding any lawsuit can shape public perception of your facility in a way that is very difficult to counteract. It is better to avoid harming your reputation in the first place than try to repair it after the fact.
5. Fall prevention protects patients’ safety, dignity and autonomy
Every single patient that comes into your facility is at risk of a fall to a greater or lesser degree. That’s why your fall management plan needs to take into account the risks that are specific to the individual so you can put into place appropriate interventions to counteract that risk.
An effective risk assessment goes deeply into a patient’s individual risk factors, including their fracture and non-fracture injury history, to provide a personalized plan tailored to the patient’s needs. This has a number of benefits besides reducing the likelihood of a fall. When a patient feels as though their personal safety is important to staff, they are less likely to worry or raise false alarms.
In addition, by having trained health professionals educate each patient individually about their specific fall risks and causes, as well as being aware of prevention strategies targeting those risks, patients can take personal responsibility for their own wellbeing and safety.
6. Fall management programs provide you with invaluable data
Any fall management program should be based in established facts and real life scenarios, which is why your fall risk analysis should be data-driven and systematic to identify specific factors unique to your environment.
Your fall risk analysis should be an ongoing process. As you collate more data, you can further improve and update your protocols to ensure that you remain at the cutting edge of fall prevention. Without this information, any attempt to reduce the incidence of falling is unlikely to succeed, especially since fall prevention solutions can vary throughout your facility depending on patient need and resources.
7. Fall management programs help prevent falls recurring
Even with the best fall management strategies in place, there will always be the risk of a fall. This is why your fall prevention program needs to include processes for post-fall management.
When a fall has occurred, you should conduct a post-fall analysis as soon as possible after the event. This needs to include all affected staff, as well as the patient where possible. Detail the events leading up to and including the fall so you know what happened and how.
See if you can determine why the fall occurred. What were the contributing factors to the fall? Was it due to medication? Recent treatment? Did you have enough staff available to assist the patient? Had they pressed the call button and, if so, how long did it take staff to respond? Were there any environmental factors that could have caused the fall, e.g. tripping hazards? Was there an element of human error?
Once you have a comprehensive understanding of the causes of a specific fall, you can use that information to improve and refine your fall management program moving forward.
8. Hospital fall management helps staff do their jobs more effectively
All your staff need to take responsibility for reducing falls causing injury, not just physicians and nurses. Everyone needs to be aware of your fall management protocols, including environmental services, IT and support staff, patient advocacy, pharmacy, physical and occupational therapy, quality and risk management, and all other stakeholders.
When setting up your fall prevention program, you may want to consider putting together a taskforce with representatives from a broad spectrum of teams and departments to ensure you put the appropriate infrastructure in place to manage the risk of falling.
Many staff may not be aware of the serious impact a fall can have, so by incorporating fall awareness into staff induction, training and practices, everyone can work together to prevent avoidable falls. You may even want to appoint an executive to oversee fall risk assessment and management to ensure that you have appropriate equipment and resources, as well as making sure that all your staff are empowered to help those patients who need assistance.
Best practice surrounding fall prevention includes standardizing your hand-off communication process and when communication is improved in one area, it tends to improve across others as well. Depending on your facility, there are a number of different approaches you can take to incorporate fall management into the communication process between caregivers. These include the use of white boards to increase awareness of fall risks to staffs across shifts, including details of fall alerts in your electronic medical records or instituting a bedside shift report process covering fall risk issues.
An effective fall management system also provides staff with simple, easy to follow instruction on what interventions are appropriate under what circumstances. When everyone is aware of what they need to be doing, it becomes everyone’s duty to put your policies into practice.
Put simply, when fall prevention strategies become a normal part of daily routines, it frees up staff’s time and energy to focus on their most important role – patient care.
 Wong C, et al: The Cost of Serious Fall-Related Injuries at Three Midwestern Hospitals. The Joint Commission Journal on Quality and Patient Safety, 2011;37(2)
 Haines T, et al: Cost effectiveness of patient education for the prevention of fall in hospital: economic evaluation from a randomized controlled trial. BMC Medicine. 2013;doi:10.1186/1741-7015-11-135