April 29, 2014
An estimated 11,000 patients die annually in U.S. hospitals from falls, but a project of Barnes-Jewish Hospital, with the Joint Commission Center for Transforming Healthcare
and six additional hospitals, was able to reduce falls with injury significantly. The 18-month “Preventing Falls with Injury” project surpassed the initial goal of reducing patient falls with injury by 50 percent and reducing all falls by 25 percent. By using sophisticated improvement method and tools, the participants reduced patient falls with injury by 62 percent and the total number of patient falls by 35 percent.
As a result of the project’s efforts, an average 200-bed hospital that uses the measurement approach and solutions developed during the project could expect to avoid 72 falls with injury and save approximately $795,000 annually based on a cost per patient fall of $11,000.
To determine the key contributing factors and develop solutions for falls prevention, the teams used a fact-based, systematic, and data-driven problem-solving methodology that incorporates tools and concepts from Lean, Six Sigma and change management.
Barnes-Jewish Hospital was able to significantly reduce the total number of falls and falls with injury by creating awareness among staff, empowering patients to take an active role in their own safety, utilizing a validated fall risk assessment tool, engaging patients and their families in the fall safety program, providing purposeful hourly rounding, and engaging all hospital staff to ensure no patient walks by him/herself. These examples are some of the targeted solutions developed to address contributing factors around why patients fall. The targeted solutions, which were thoroughly tested and proven effective during the project, are strategies developed to mitigate contributing factors. In all, the hospitals and the Center developed a total of 21 targeted solutions during the course of the project.
“As solutions were developed, targeted to specific contributing factors within our organization, we discovered that falls prevention was not a set of disparate and unrelated activities,” said Laurie Wolf, lead performance improvement engineer at Barnes-Jewish. “Instead, preventing falls was a key strategy in preventing or minimizing injury to patients. We are proud that our hospital has made it a priority to create awareness among all staff and empower patients to take an active role in their own safety.”
“Patient falls are a serious problem that have received a great deal of attention, yet defy easy solutions,” said Erin DuPree, MD, vice president and chief medical officer, Joint Commission Center for Transforming Healthcare. “Barnes-Jewish Hospital is leading the way in developing strategies that keep patients safer. By targeting interventions to the specific causes of falls and using these approaches, real and substantial improvement can be achieved.”
The additional six project participants included:
- Baylor Healthcare System, Texas
- Fairview Health Services, Minnesota
- Kaiser Permanente, California
- Memorial Hermann Healthcare System, Texas
- Wake Forest Baptist Health, North Carolina
- Wentworth-Douglass Hospital, New Hampshire
Barnes-Jewish Hospital is a 1,315 bed teaching hospital affiliated with Washington University School of Medicine in St. Louis, Mo. The hospital has a 1,763 member medical staff, with many recognized as "Best Doctors in America." Barnes-Jewish is a member of BJC HealthCare, which provides a full range of health care services through its 13 hospitals and more than 100 health care sites in Missouri and Illinois. Barnes-Jewish Hospital is also consistently ranked on the elite honor roll of America’s “Best Hospitals” by U.S. News & World Report.
About the Joint Commission Center for Transforming Healthcare
Created in 2008 as a non-profit affiliate of The Joint Commission, the Joint Commission Center for Transforming Healthcare aims to solve health care’s most critical safety and quality problems. The Center’s participants – some of the nation’s leading hospitals and health systems – use a systematic approach to analyze specific breakdowns in care and discover their underlying causes to develop targeted solutions that solve these complex problems. In keeping with its objective to transform health care into a high reliability industry, The Joint Commission shares these proven effective solutions with the more than 20,000 health care organizations it accredits and certifies. Hospitals have made significant advances in quality – even better results are now achievable. Hospitals and The Joint Commission are working together to improve systems and processes of care. Learn more about the Center at www.centerfortransforminghealthcare.org.