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Falling to Zero

Cedars-Sinai Achieves Zero Patient Falls With Renewed Efforts

Taking a major step forward in fall prevention, Cedars-Sinai achieved zero patient falls for the week ending Jan. 24, and only three falls the following week.

Inservice trainings on units with high fall rates and renewed fall prevention education for everyone from physicians to certified nurse assistants and nursing communication technicians made the achievement possible, said Richard Riggs, MD, chair and medical director of Physical Medicine and Rehabilitation, who co-sponsors the Quality Council Falls Collaborative with Linda Burnes Bolton, DrPH, RN, FAAN, vice president and chief nursing officer.

While all staffers are being urged to call for help if they see a high-risk patient attempting to move without assistance, physicians have a special responsibility to support fall precautions because "patients listen to doctors more than any other caregiver," said Peachy Hain, MSN, RN, director of Medical, Surgical and Rehabilitation Services and nursing lead for the Falls Prevention Committee.

"Having everyone understand why every caregiver has a role in preventing falls and creating a culture of keeping patients safe — that's what has made the difference," Riggs said. "We've put the right foundation in place and will continue to work with the units, monitor performance data and share best practices to build on our success."

Unassisted falls cause serious injury to 90,000 patients in hospitals across the nation each year. Cedars-Sinai had been averaging 30 unassisted falls per month when the collaborative launched its 2013 campaign to reduce unassisted falls by 50 percent. This year, the collaborative aims to meet that target for three consecutive months.

While the medical center already has a robust fall prevention bundle, the inservice trainings focused largely on the dangers of leaving high-risk patients alone in the bathroom, which accounts for the majority of unassisted falls. More than 300 Cedars-Sinai staff members attended the trainings, which included instructions that nurses go up the chain of command if patients refuse to comply with precautions.

"We continue to have challenges with patients who refuse to comply," Riggs said. "But the reality is, once we have created a culture around the precautions, the patients and families go along with them more often."