Falls Prevention: New Ways of Thinking about a Continuing Challenge

When researchers at the University of Pittsburgh Medical Center (UPMC), Pennsylvania, recently published their findings regarding risk factors associated with patient falls in hospitals, they concluded that “advances in fall prevention require a new way of thinking.” The researchers—led by Jacques E. Chelly, M.D., Ph.D., vice chairman of clinical research, University of Pittsburgh School of Medicine—noted that after a decline in falls rates in the late 1980s and early 1990s, falls rates started to rise in the late 1990s and continued to increase into 2008, when Chelly’s research was published in the September 2008 issue of the Journal of Patient Safety.

Chelly is “bold in saying we need new approaches,” says Susan Christie Martin, M.S.N., director, Donald D. Wolff Jr. Center for Quality Improvement and Innovation at UPMC. She agrees with Chelly, noting, “We can’t do things the way we’ve always done them.” Kathleen M. Hale, R.N., UPMC director, corporate risk management and patient safety, agrees, adding, “Our patient population is older, sicker, and its medications are considerably different” compared to populations in the past.

In late 2008, the center spearheaded a systemwide effort to overhaul its falls prevention strategies, and it started to deploy the new approaches in January 2009. Other hospitals nationwide—including facilities in Rochester, New York; Philadelphia; and St. Louis, Missouri—are revamping and reenergizing their falls prevention programs to address a problem that continues to vex healthcare facilities.

While long recognizing that falls prevention is “the right thing to do” for patients, hospitals are also responding to external pressure to reduce patient falls. In 2005, the Joint Commission issued a National Patient Safety Goal requiring accredited hospitals to reduce the risk of patient harm from falls. The accrediting organization has reiterated the goal every subsequent year, including in 2009. Although Barnes-Jewish Hospital in St. Louis has had a falls prevention program in place since 1988, “the program got a lot of attention from senior leadership...