New tool aims to prevent inpatient falls


The Joint Commission Center for Transforming Healthcare has released its Targeted Solutions Tool (TST) to help prevent hospital inpatient falls and falls with injury. 

The Preventing Falls TST is an online resource that provides a step-by-step process to assist hospitals in measuring fall and fall with injury rates, identifying and measuring barriers to fall prevention, and implementing the Center’s solutions for falls prevention that are customized to address specific barriers.

Using the solutions included in the TST, a typical 200-bed hospital could potentially reduce the number of patients injured from a fall from 117 to 45 and avoid approximately $1 million in costs annually through fall prevention efforts.

“Hundreds of thousands of patients fall in hospitals every year and many of these falls result in moderate to severe injuries that can prolong hospital stays and require the patient to undergo additional treatment. These outcomes for patients are unacceptable,” said Dr Erin DuPree, vice president and chief medical officer, Joint Commission Center for Transforming Healthcare. “We are encouraging hospitals to use the TST to improve patient safety and reduce patient falls.”

The Center addressed the issue of patient falls because it is a persistent issue in health care and falls have been identified by the Centers for Medicare & Medicaid Services (CMS) as an event that is preventable and should never occur. 

CMS has also identified “falls and trauma” on its list of hospital acquired conditions for which reimbursement may be impacted, specifically for falls that result in fractures, dislocations and intracranial injuries. Serious injuries, on average, add 6.3 days to a patient’s hospital stay and cost about $14,056.

The TST was developed with the initial assistance of seven collaborating hospitals. Following the original participating group, five additional health care organizations participated in a pilot to test the fall prevention methodology. These organizations validated the project’s contributing factors, measurement tool and solutions for improving their falls and falls with injury rates.

Working with the Center, the original participating hospitals were able to reduce the rate of falls by 35 percent and falls with injury by 62 percent. 

Their efforts included creating awareness among staff, empowering patients to take an active role in their own safety, using a validated fall risk assessment tool, engaging patients and their families in the fall safety program, hourly rounding with scheduled restroom use for patients, and engaging all hospital staff and patients to ensure no patient walks without assistance. 

These examples are some of the 21 targeted solutions developed to address contributing factors around why patients fall.

The Center used Robust Process Improvement (RPI) to identify the causes of patient falls and develop solutions to prevent them. RPI is a systematic, data-driven problem-solving methodology that incorporates tools and concepts from Lean, Six Sigma and change management.

The Preventing Falls TST is complimentary to Joint Commission-accredited organizations. They may access the TST through the Center’s website or on their secure Joint Commission Connect extranet. 


The Joint Commission Center for Transforming Healthcare, Dr Erin DuPree, US