A new program of the Inpatient Rehabilitation Center at The Moses H. Cone Memorial Hospital has reduced the patient fall rate by about two-thirds.

"It really is helping because we are heightening awareness of fall risk and streamlining the process of how we intervene to prevent falls," says Nidra Ricks, RN, Acute Rehabilitation, 4000. "Falls lead to longer lengths of stay, so if we can prevent someone from falling, then we can help that person return to his or her home and community a lot earlier."

First, the staff ensures that patients and/or family members are aware of each patient’s safety plan, a neon yellow form posted in his or her room. This plan addresses everything from swallowing precautions and what needs to be left within the patient’s reach to whether he or she can be left alone and how much assistance is needed with moving. This sheet is updated as a patient’s situation changes, but at least weekly.

Staff members also use a newly developed decision-making tree, or flow chart, to determine each patient’s fall-risk level and recommended interventions. These levels are color-coded for degree of risk – yellow, orange and red.

"Last year at this time, we were analyzing the causes of falls and we recognized that our nurses and therapists were not using consistent criteria to select the most effective fall-prevention intervention for each patient," says Anne Macner, Executive Director, Post Acute Rehabilitation. "This program guides the decision-making process and helps keep our patients safe."

Since the program began, the fall rate at the Inpatient Rehabilitation Center has dropped from 14 per 1,000 patient days to 5 per 1,000 patient days.