Reducing falls in inpatient older adults: Quality improvement initiative

Background: Falls and fall-related injuries are common among older adults, adversely affecting their functional independence and quality of life. By 2043, one in three Canadians falls each year, resulting in 85% of hospitalizations, which cost $2 billion annually. Objective: This study aimed to reduce inpatient falls among older adults with cognitive impairment in a rural Ontario hospital. Methods: A fall reduction project was implemented at the hospital to improve clinical care since January 2024. The project included fall risk screening, ensuring a fall bundle was in place, and monthly meetings with hospital staff and patient representatives to identify potential barriers and facilitators to the project. The project involved two components: 1) nurses evaluating fall risk using validated tools and 2) implementing a fall prevention bundle. Data was retrieved from the hospital's electronic medical records. The outcome of interest was the fall rate before and after the intervention. Results: The initiative has reduced the inpatient fall rate from 16.25 falls per 1000 bed days in 2023 to 11.33 falls per 1000 bed days in 2024. Almost 57% of people who fell were cognitively impaired. Conclusions: The project reduced the inpatient fall rate by 30% within a year. The involvement of patients and their families in the initiative has made the project meaningful to the community. However, no change was observed in the 30-day readmission rate, prompting the research team to conclude that inpatient interventions are insufficient. Further research on collaborative care involving the pharmacy department and community partners is recommended.