Hospitals are moving to stop a potential serious hazard: costly patient falls that could result in injuries or death.
The catalyst for the changes is the national Joint Commission on Accreditation of Healthcare Organizations. The nonprofit, which gives key accreditation to hospitals, now requires them to have formal fall prevention plans on their books as a condition for being accredited.
The group’s requirements include creating a system to assess and track every patient’s risk.
There’s another reason hospitals are pushing prevention: Falls may lead to lower healthcare costs.
Blackwood, N.J., consulting firm fallPREVENT LLC said hospitals typically see additional rehabilitation costs of $15,000 to $30,000 for a serious patient fall.
And hospital officials worry that serious falls could be a growing legal risk.
Placentia-Linda Hospital, one of five Orange County hospitals owned by Tenet Healthcare Corp., said falls are a key part of its patient safety program. Placentia-Linda said it had a fall prevention plan before the Joint Commission’s directive, said Judy Lawrence, the facility’s patient safety manager.
“We’ve always had a fall prevention program,” Lawrence said. “The fact that the Joint Commission has now made it a national patient safety goal (created) an opportunity for us to take another look at it, make sure we were doing what we needed to do and see what else we could add to it to prevent falls.”
Placentia-Linda’s fall prevention initiative includes regular assessments of its patients’ risk for falling. As part of its program, pharmacists must examine patients’ risks for falls based on their medication group, such as sedatives, narcotics or anesthetics.
The pharmacist then will contact the patient’s physician to figure out if the patient should be on the hospital’s fall protection watch.
Besides sedatives, hypnotics, analgesics, anti-hypertensives, laxatives and diuretics also have been linked to increased fall risks. Patients taking several drugs at once are considered among the riskiest for falls.
The hospital has a 15-member committee made up of representatives from nearly all of the hospital’s departments. It meets monthly and is charged with examining patient safety issues, Lawrence said.
She said the hospital’s new hires, during their orientation, are given lots of information about patient safety issues, particularly preventing falls.
“I make rounds and monitor our fall precaution there’s plenty of education and follow-up with our staff,” she said.
Meanwhile, fall prevention efforts at Saddleback Memorial Medical Center in Laguna Hills include making sure that patients have nurse call lights within reach, keeping hospital rooms clean and giving patients non-skid slippers, said Steve Erickson, the hospital’s director of rehabilitation services.
“Every patient is assessed for risk of falling,” Erickson said.
If a patient’s risk is considered “moderate,” he said, they receive more frequent checks and bed alarms.
High-risk patients are moved closer to nursing stations and closely monitored, he said.
Saddleback’s fall risk assessment has found that patients with incontinence often are at a higher risk for falls. That’s led the hospital to enact routine toileting and provide bedside commodes, if necessary.
Besides the inpatient program, Saddleback also developed a fall prevention program for patients at home.
The move was inspired by nearby residents who repeatedly showed up at Saddleback’s emergency room with fall-related injuries.
“Our ER physicians were noticing that not only more and more people were coming in for (fall-related injury) treatment, but they were the same people,” Erickson said.
Exercise programs are a key part of the outpatient fall prevention push.
Saddleback provides service to Leisure World in Laguna Woods. The housing community is made up almost entirely of people over 55 years old.
On a national level, the Institute for Healthcare Improvement and Veterans Administration are among the groups that have sprung up to help hospitals create fall prevention programs. San Diego-based Premier Inc., a buying group of nonprofit hospitals, also is involved.
