Fresh Thinking about Falls in Hospital

Stalled on Reducing Falls in your Hospital?

Today is the first day of fall, the autumnal equinox, when the day and night are equal and we move into a season of darkness.  As many hospitals continue to experience falls with injuries, some very serious injuries like hip fractures or subdural hematomas, I thought today, on Fall Prevention Awareness Day, it would be a good time to shine a light on some fresh ideas about preventing injuries from falls and immobility, especially if you are feeling stalled or stuck.

To get you thinking, ask yourself these five thought provoking questions that point to common pitfalls observed in hospitals without improvement in reducing injury from falls and immobility.
  1. Do you minimize a patient to a fall score rather than address their modifiable risk factors and appreciate their unique abilities?
  2. Do you lump all high fall risk patients into one bundle of interventions or do you segment and prioritize your patients highest risk for injury using the ABCS tool? (Age > 85, Bone disease, hx of fx, Coagulation issues, Surgery during current hospital course)
  3. Is keeping patients in bed with the use of bed alarms your primary means to prevent falls or do you strive to maintain functional mobility through regular ambulation from day one? “If they came in walking, keep them walking.”
  4. Do you rely on patients being compliant with “Call don’t fall” or do you take the time to teach them what their personal risk factors are for a fall and for injury and engage them in a safe mobility plan? (Example: White board: “I could fall because…..” “I could be injured if I fall because….”)
  5. Do staff and patients feel uncomfortable with arms-length toileting supervision for vulnerable patients who are high risk for fall or injury or are leadership, physicians, patients and staff all on the same page supporting the appropriate level of toileting supervision for those patients who need it?

If you said yes to any of these common pitfalls, it might be time to look through a new lens.  Cynosure has created Discovery Tools  for the most common hospital harms.  The Cynosure Falls Discovery Tool  provides a quick snapshot of your opportunity trends from your most recent falls with injury, allowing you to quickly hone in on an area that you can target your improvement efforts upon.

Before you rush off to access the discovery tool, a word of advice.

Do not go at this alone. Instead of trying to do more with less, do more with many. While you gather your data from the discovery tool, work to ensure you have engaged leadership, a physician champion, rehab, pharmacy, respiratory, as well as non-clinical departments like environmental services and plant ops. Most importantly, involve the staff who work directly with patients. Bedside care nurses, nursing assistants, therapists, food service and environmental workers all have so much to offer in identifying and testing solutions.

Need help engaging more people in this important work?

Access the Cynosure  Getting There Guide for inspiration and ideas for engaging the missing people or departments in your work to reduce injury from falls and immobility.  Wouldn’t it be a dream if everyone’s job was quality?  Dream big my friend!

Wishing you a happy fall and a light of inspiration as you approach your improvement work.


Jackie Conrad, Improvement Advisor and Falls Subject Matter Expert

Let’s Bust some Myths about Falls and Elders on National Fall Prevention Day!


In honor of National Fall Prevention Day which kicks off on the first day of fall, September 22, let’s shine a light on some common myths that elders hold about falls so that we can better prepare our older adults to stay safe AND active in the community.

The National Council on Aging (NCOA) published 10 Common myths that we, as clinicians can help debunk for our community dwelling seniors.   Access the full document here.

Many older adults think falls are a normal part of aging. The truth is, they’re not. Most falls can be prevented, and individuals have the power to reduce their risk. Exercising, managing medications, having  vision checked, and making  living environment safer are all steps older adults can take to prevent a fall.

Debunking 10 Myths Elders Hold About Falls

Myth 1: Falling happens to other people, not to me.

Myth 2: Falling is something normal that happens as you get older.

Myth 3: If I limit my activity, I won’t fall.

Myth 4: As long as I stay at home, I can avoid falling.

Myth 5: Muscle strength and flexibility can’t be regained.

Myth 6: Taking medication doesn’t increase my risk of falling.

Myth 7: I don’t need to get my vision checked every year.

Myth 8: Using a walker or cane will make me more dependent.

Myth 9: I don’t need to talk to family members or my health care provider if I’m concerned about my risk of falling. I don’t want to alarm them, and I want to keep my independence.

Myth 10: I don’t need to talk to my parent, spouse, or other older adult if I’m concerned about their risk of falling. It will hurt their feelings, and it’s none of my business.

As clinicians, we may take for granted that patients understand how they can stay independent.  and minimize their risk for falling by staying active and modifying their home environment. Please use this information and the CDC’s Project STEADI resources to promote fall safety awareness and improve your transitions back to the community.

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