Article comparing the 3 Fall tools

Article comparing the 3 Fall tools - R E V I E W S A N A LY...

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Pennsylvania Patient Safety Advisory Vol. 9, No. 3—September 2012 ©2012 Pennsylvania Patient Safety Authority Page 73 INTRODUCTION Falls are the leading cause of injury-related death in adults over age 65, with death rates rising sharply over the past decade. One out of three adults over age 65 falls each year, and adults age 75 or older are four times as likely to suffer an injurious fall as adults age 65 to 74. 1 Hospitalization increases this risk due to the interplay of intrinsic falls risk factors (e.g., symptoms of illness, treatment side effects) and extrinsic falls risk fac- tors (e.g., unfamiliar environment, intravenous lines and other attachments). 2 The majority of falls can be attributed to a physiologic cause, with 78% of falls labeled “anticipated” (i.e., physiological falls that can be predicted in patients exhibiting clini- cal signs that contribute to increased falls risk), and 8% labeled “unanticipated” (i.e., physiological falls that cannot be predicted before their first occurrence). The remain- ing 14% of falls are labeled “accidental” (i.e., the result of mishaps often attributed to environmental causes). The differentiation of fall types is important because methods for prediction and prevention differ according to the fall type. Anticipated physiologi- cal falls can be prevented through screening for falls risk factors, in-depth assessment, and implementation of targeted prevention strategies. Accidental falls can be prevented through environmental controls that seek to provide a safe environment. Unantici- pated physiological falls are, by their nature, not preventable at first occurrence. 3 There is increasing regulatory and reimbursement pressure on hospitals to prevent patient falls. In 2002, hospital falls resulting in patient death or serious disability were labeled as serious reportable events by the National Quality Forum (NQF). 4 In 2008, these serious reportable events were labeled as hospital-acquired conditions (HACs) subject to nonpayment by the Centers for Medicare and Medicaid Services (CMS). 5 And beginning in federal fiscal year 2015, hospitals in the worst-performing quartile in terms of national HAC rates will receive a 1% reduction in Medicare payments across the board for all discharges as part of the Patient Protection and Affordable Care Act. 6 Considering the growing population of older adults and their increased risk of falls and falls injuries, the cost of falls is expected to grow in terms of both human suffering and financial cost to individuals and healthcare providers. CMS has recognized this as a focus area for improvement as part of the Partnership for Patients (PFP), an initiative that aims to decrease HACs by 40% by the end of 2013. 7 Recognizing that not all falls are preventable, the specific goal related to falls is “to cut the number of preventable fall injuries in half while maintaining or increasing patients’ mobility.” 8 The Pennsylva- nia Patient Safety Authority is currently partnering with the Hospital and Healthsystem
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