Improvement Stories:
Reducing Patient Falls
The Partners Chief Nurses Council has been working on reducing the rate of patient falls since 2002. Beginning in 2007, a new team was formed as part of High Performance Medicine to apply best practices in falls prevention. This new group - the Falls Prevention Team - is sponsored by the Partners Nursing Quality Leaders, and comprises nurses from across the system who continue to study, improve and standardize the approaches to reducing patient falls and falls with injury.
The Falls Prevention team works in several different areas: research, risk assessment, and ensuring competency in the standard falls assessment tool, the Morse Falls Risk Score. On the research side, four Partners hospitals were funded by a grant from the Robert Wood Johnson Foundation to study how to tailor specific interventions to each particular patient's needs. The Falls Prevention Team has worked to standardize the fall risk assessment commonly used by bedside nurses, and embed the tool into the computer system at each facility. Each year, the Team conducts a competency review to make sure all nurses across the system are getting the training they need to use the falls risk assessment tool most effectively.
Partners nurses test and implement a variety of tactics to prevent falls: patient bracelets, signs at the bedside, bed lifts to make it easier for patients to get up, and others. One of the most innovative is “Comfort Rounds,” when nurses and nursing assistants on a hospital unit work together to “round” on or visit every patient on an hourly basis. By checking in to offer assistance with bathroom needs, changing the position of immobile patients, offering food or drink, assessing pain, providing education, or attend to other personal needs, the staff were able to reduce the rate of falls among their patients while improving the sense of teamwork among the nurses and nursing assistants.
This important work is ongoing at Partners hospitals and the lasting effect of these interventions on reducing falls is unknown at this time.