Focus on Falls: Prevention Strategies That Work

"The two main goals of falls prevention programs in healthcare settings are to enhance patient safety and to minimize the financial impact of falls," said Karen Holloway, risk management analyst at ECRI, during the introduction to ECRI's recent Web conference, "Focus on Falls: Prevention Strategies in Healthcare Settings." As moderator of the Falls Web conference, Holloway established a framework for faculty members to present current strategies and proven methods for falls prevention and reduction in both acute and long-term care facilities.

Citing the magnitude of the problem in terms of the human and financial toll on healthcare facilities, the Web conference presenters unanimously agreed that the prevention and reduction of falls continues to deserve the attention of risk managers, patient safety officers, clinicians, and administrators. Indeed, while estimates of the frequency of falls are not exact, incidence rates in the hundreds of thousands per year have been reported in acute care settings, and substantially higher rates have been found in nursing homes—over 1.2 million falls occurred in nursing homes for the year 2005.1 Furthermore, serious injury occurred in 30% of acute care falls and 20% of nursing home falls. The elderly are particularly affected by falls. While death is the most serious result of a fall, the most common serious injury is hip fracture. Almost one-quarter of people who sustain a hip fracture as a result of a fall die within a year, and 50% of them never regain their former function level.2 The cost of treatment for falls is equally astounding. Based on figures published by the National Center for Injury Prevention and Control and the Wall Street Journal, the cost of treating falls that resulted in serious injury in acute care was $1.08 billion and the cost of treating falls that resulted in serious injury in nursing homes was $4.9 billion.

Noting a steady increase in the number of falls-related sentinel events reported,* the Joint Commission on Accreditation of Healthcare Organizations introduced in 2005 a National Patient Safety Goal for accredited organizations aimed at reducing the risk of injury from falls. The patient safety goal remains in place for 2007. On the regulatory side, the Conditions of Participation for healthcare facilities in the federal Medicare/Medicaid program require facilities to provide care in a safe and accident-free setting.3 Long-term care facilities can face civil monetary penalties for placing residents in...