Fall prevention is not a destination; it is a journey. The journey begins with use of an evidence-based fall risk assessment. It continues with care interventions through increased staff awareness and education, emphasis on meeting elimination needs, monitoring patient activity, assessment of the environment, and providing important patient safety information.

We can work with your team to discuss your fall prevention challenges and offer insights to help you on your fall prevention journey.

Ten questions published with the program evaluation

1. 01

   Do you know if your fall prevention program is working?

   Having data about injurious falls is a necessary element of any successful program. It is important to have injurious fall rates and severity classification with a trend analysis that normalizes for the unit or facility over time. In hospitals, a ‘rolling twelve month average’ of an index (per thousand patient days) is often used. In other environments such as long term care or skilled nursing, occupied bed days may be used. Population health uses the denominator of the group.

2. 02

   Do you apply research and quality improvement to your delivery of care?

   Evidenced-based approaches should guide performance and practice for high-quality and safe care delivery. When evidence is utilized to design a person-centered approach to care the delivery and experience is enhanced for the individual and falls will be prevented.

3. 03

   Does your current fall program provide person-centered care?

   Injurious falls occur when risk factors either go ‘overlooked’ or when the person’s condition changes and fall risk increases without appropriate interventions to proactively reduce the risk factor’s presence.

4. 04

   Are your care interventions working?

   Effective interventions must change with the patient’s condition. Risk factors should be used to ‘prescribe’ interventions so that fall risk can be reduced whenever possible. For example, altered elimination should have a care plan aligned with toileting while seeking to understand the ‘root’ cause of why it is present to begin with.

5. 05

   Can you resolve a fall prevention problem in your organization?

   Professional practice providers must be empowered with data for their area and knowledge to engage in practices of ‘highly reliable’ care that seeks to make care safe, effective, and timely. Assuring that everyone, licensed and non-licensed, personnel are familiar and act as part of the ‘care team’ with deference to expertise at any level, will make the environment safer. Care assistants and housekeepers are valuable members of the care team and should be included in education.

6. 06

   Is your fall risk assessment integrated into your Electronic Health Record?

   The electronic record can be a very effective tool, and Meaningful Use national standards have helped to drive evidence into various platforms. Electronic data capture and alerts can help to prompt caregivers, but they can also cause or contribute to ‘alert fatigue’. They should be used judiciously.

7. 07

   Do you create informative reports and summaries of fall prevention results?

   Feedback loops for care providers and other members of the care team should be brief to increase the likelihood of an effective local action plan. Utilize graphics to visualize causes and outcomes of fall events and look for special cause variations within the data. Assure that unit-based clinical practice committees, departments, groups and caregivers, have all of the information they need to help them solve for causation at their level with their data. They usually know best what is needed to prevent falls.

8. 08

   Do you conduct cost/benefit analysis based upon defined outcomes related to fall prevention?

   Evaluation is an important part of your program. Knowing the overall impact and approach on patient risk, claims, reimbursement care, deposition time, attorney defense expense etc., helps build the case for administrative support in a cost conscious environment.

9. 09

   Has your current fall program reduced your injurious fall rate index?

   Fall prevention efforts must be consistently monitored, so improvements and adjustments can be made in correlation with the injurious fall index. Does it take a fall event to move the culture into action, or do the fall cases demonstrate effective assessment, reassessment, and aligned interventions based on patient needs? A constant injurious fall index demands attention, and it may reflect preventable falls have been reached or it may suggest no change of a care provider’s behavior to proactively advocate for risk reduction. An individualized person-centric fall risk assessment is designed to initiate a plan for prevention.

10. 10

    Are your fall prevention program results benchmarked with your organization over time and/or with national rates?

    Fall prevention programs should be compared not only to national norms, but against their own performance over time. Benchmarking can be helpful for comparison purposes, but each fall should be evaluated based upon outcomes of the fall event rather than simply documenting how many falls have occurred. Highly reliable care and healthcare reform demands organizations to adopt best practice models that provide high-quality, low-cost care that can demonstrate high-quality, value-added care to persons and payers.