Reduction of Falls and Fall-Related Injuries in Highly Engaged, Low Performing Hospitals

Nature and scope of the project: The Hospital Engagement Network (HEN) is a collaborative effort between the American Hospital Association and Hospital Research and Education Trust (HRET) to reduce preventable harms in healthcare.  Project sponsorship and oversight is provided by the Centers for Medicare and Medicate Services.  The Missouri Hospital Association has an active HEN with 94 participating hospitals.  HEN goals are to reduce preventable harms in key areas: adverse drug events, catheter associated urinary tract infections, central line associated blood stream infections, falls, pressure ulcers, readmissions, surgical site infections, ventilator-associated pneumonia, and venous thromboembolism.  This project focused on reduction of falls and fall-related injuries in Missouri hospitals.  According to HRET, each fall increases costs by approximately $11,250.  Effective fall prevention can provide a safer patient environment and reduce hospital costs from injuries.

Synthesis and analysis of supporting literature:  Literature was reviewed to determine best practices in fall risk assessment and prevention.  A fall prevention toolkit was created and included evidence-based resources such as adult, pediatric, and mental health-specific risk assessment tools and guidelines for use of low beds, helmets, hip protectors, patient contracts and post fall huddles. 

Project implementation:  Falls data collected since January 2012 has been used to complete a Harm Across the Board storyboard for many HEN hospitals.  Hospitals with higher than average fall rates were invited to participate.  An individualized gap analysis determined current practice and areas for potential improvements for each hospital.  Coaching in best practices was provided via in-person site visits or conference calls.  A fall prevention seminar, held in June 2014, allowed high-performing hospitals to share successful fall reduction strategies.

Evaluation criteria:  The goal is to reduce hospital fall rates by 40%.  If a hospital has increased fall rates, additional coaching and resources are provided. 

Outcomes:  Results of preliminary analysis of data from 23 hospitals are reported.  Since January 2013, 106 falls have been prevented resulting in an estimated cost savings of $1.192 million. 

Recommendations:  Assessment, coaching, and data collection will continue through December 2014.  If interventions are successful and sustainable, the fall prevention program could expand to other settings.