Posted: April 30th, 2022

Analyzing Patient Fall Rates in Healthcare Settings

Analyzing Patient Fall Rates in Healthcare Settings

Patient falls are a common and serious adverse event that can occur in hospital settings, especially among elderly patients. Falls can result in physical injuries, psychological distress, increased length of stay, higher costs and even death. Therefore, preventing falls and fall-related injuries is a key indicator of quality and safety in healthcare.

According to the Agency for Healthcare Research and Quality (AHRQ), about 700,000 to 1 million hospitalized patients fall each year in the United States, with a rate of 3 to 5 falls per 1,000 occupied bed days . In Switzerland, a multicentre cross-sectional survey found that the unadjusted fall rate was 2.7 per 1,000 patient days, with significant variation across hospitals . In the long-term care setting, the average rate of falls is estimated to be 1.5 falls per nursing home bed annually, with about 50% of residents falling each year .

Several patient-related factors have been identified as risk factors for falling in hospital settings, such as age, sex, care dependency, history of falls, cognitive impairment, medication use and comorbidities. These factors are not modifiable by care, but they can be assessed and used to adjust fall rates for fairer comparison and benchmarking among hospitals. Risk adjustment can also help identify hospitals that perform better or worse than expected based on their patient characteristics, and thus inform quality improvement efforts .

In addition to assessing patient-related risk factors, hospitals should also implement evidence-based fall prevention practices that target modifiable aspects of care, such as environmental hazards, staff education, patient education, multifactorial interventions and post-fall management. The AHRQ has developed a toolkit for preventing falls in hospitals that provides guidance and resources for measuring fall rates and fall prevention practices, implementing best practices and evaluating the impact of improvement efforts .

Preventing falls and fall-related injuries in hospital settings is a complex and challenging task that requires a multidisciplinary and multifaceted approach. By measuring fall rates and fall prevention practices, adjusting for patient-related risk factors and implementing best practices, hospitals can improve the quality and safety of care for their patients.

Bibliography
: Agency for Healthcare Research and Quality. Preventing Falls in Hospitals: A Toolkit for Improving Quality of Care. https://www.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/index.html (accessed January 9th 2024).
: Bernet NS, Everink IHJ, Schols JMGA et al. Hospital performance comparison of inpatient fall rates; the impact of risk adjusting for patient-related factors: a multicentre cross-sectional survey. BMC Health Serv Res 2022;22:225.
: Tinetti ME, Williams CS. Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med 1997;337:1279-84.
: Lake ET, Shang J, Klaus S et al. Patient falls: association with hospital magnet status and nursing unit staffing. Res Nurs Health 2010;33:413-25.
: Currie L. Fall and injury prevention. In: Hughes RG (ed). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008.
: Oliver D, Healey F, Haines TP. Preventing falls and fall-related injuries in hospitals. Clin Geriatr Med 2010;26:645-92.

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