By: Hurley Smith
Patient falls are a significant safety concern for patients in hospital settings. They can cause injury, compromise healing, and increase the patient’s exposure to risk by prolonging their length of stay. In the Department of Medicine, we recognized the need for a multidisciplinary team approach to fall prevention and took steps to implement it.
Through our efforts, we learned several key points about fall prevention. First, we realized the importance of meeting more frequently to discuss fall prevention strategies. We found that a more multi-disciplinary approach to GAMBA (Goals, Assessment, Measures, Barriers, and Accountability) rounds allowed for a more comprehensive understanding of the issues and helped us identify opportunities for improvement.
We also recognized that falls are a vast quality issue and that it is not possible to find a solution for everything. Therefore, we had to limit our scope and prioritize our efforts based on what would have the most significant impact. This approach helped us focus on the most critical areas and achieve the greatest results.
During our analysis, we identified incorrect use of falls risk assessment and bedside mobility assessment tools. These findings helped us develop new guidelines and educate staff on the correct use of these tools. Additionally, we discovered that there were no standards of practice for hourly rounding, despite it being an expectation of Stanford Healthcare. Our team developed new guidelines for purposeful rounding, decreasing the incidence of falls.
Polypharmacy was another area of concern in fall prevention as it is complex in nature, and there were no current interventions to reduce falls related to polypharmacy. To address this issue, working with EPIC optimization team and pharmacy to appropriately address these concerns.
Our multidisciplinary approach to fall prevention has had a significant institutional impact. Every reduction in falls is a reduction in safety events, and patients who do not have in-patient falls are 2.4 times more likely to be discharged earlier. By implementing our new fall prevention protocols, we have decreased the incidence of falls and improved patient outcomes, which has led to increased patient satisfaction and reduced costs.
In conclusion, the implementation of a multidisciplinary team approach to fall prevention in the Department of Medicine has been successful in reducing the incidence of falls and improving patient outcomes. Through our efforts, we learned the importance of meeting frequently, prioritizing our efforts, and developing new protocols and guidelines. Our approach has had a significant institutional impact and has improved patient safety and satisfaction while reducing costs. We hope that our experience can serve as a model for other healthcare organizations looking to implement similar fall prevention programs.