Hanover Hospital Wins Recognition for Dramatically Reduced Number of Falls

Hanover Hospital is proud to be awarded APEX (Achieving Patient Care Excellence) recognition for reducing the overall number of inpatient falls by a dramatic 60 percent since 2005 and surpassing a statewide benchmark for the 11-month period ending in June 2007.

The VHA (Voluntary Hospitals of America) Pennsylvania APEX Award is given to recognize member organizations that have differentiated themselves by demonstrating extraordinary levels of clinical performance. Hanover was among 27 hospitals which collaborated with VHA to address and reduce the incidence of patient falls.

According to Gary Grant, Director of Quality Improvement, the hospital put together a Fall Prevention Team in 2004 to look at the high number of patient falls, and to find a way to reduce that number as much as possible. At that time, the rate was 7.75 falls per 1,000 patient days.  

The team of nursing, pharmacy, physical therapy, pediatrics and information technology staff, created a Fall Assessment form which assigns a “fall risk score” to patients based on their age, number of medications and their history of falls. On admission, every patient receives a Fall Assessment based on those and other factors. 

If the assessment score totals 10 or more, the patient is considered to be at high risk for a fall, and Fall Risk Intervention is implemented. From that point on, the patient’s risk factors are re-evaluated by each nursing shift.  During the course of the patient’s stay, their fall status can change, sometimes to the point where they are no longer considered high risk. 

The Fall Prevention Team also constantly researches other patient safety devices such as gait belts, tether alarms for beds and chairs (which signal nursing if the patient gets up), and tab alarms which play a pre-recorded family members voice, reminding the patient not to get out of bed without assistance.

“We saw a marked change right away,” said Grant about the assessment process, implemented in June, 2005. Data at that time showed that the fall rate had already decreased from 7.75 to 6 falls per 1,000 patient days. Ongoing staff education and awareness provided by clinical unit educators and nurse directors proved to be extremely effective in figures decreasing even further. To date in 2007 Hanover has sustained a rate of less than 3.5 falls per 1,000 days, cutting the rate overall by 60% since 2005.

However, even one fall is too many, and has a tremendous impact on both the patient and the hospital. By reducing the number of falls, these costs will decrease dramatically, plus reassure patients of the high quality level of care our hospital provides.

 “Our ultimate goal is zero falls,” said Grant, adding that this is challenging, especially in a hospital setting. “Everyone needs to be commended on this remarkable progress,” he noted, “on the ongoing efforts of nursing staff and the Fall Prevention Team.”