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Evaluation of a Novel Fall Prevention Program at Inpatient Rehabilitation Hospital

Jess M. Roland, DO (University of Missouri - Columbia, Columbia, Missouri); Clifford R. Kissling, MD; Joseph E. Burris, MD; Kelli Buchanan; Benjamin Gill, DO, MBA

Meeting: AAPM&R Annual Assembly 2021

Categories: Practice Management, Leadership, and Quality Improvement (2021)

Session Information

Session Title: AA 2021 Virtual Posters - Practice Management, Leadership, and Quality Improvement

Session Time: None. Available on demand.

Disclosures: Jess M. Roland, DO: No financial relationships or conflicts of interest

Objective: Evaluating the effectiveness of an interdisciplinary fall risk stratification program

Design: Retrospective case-control studySetting : Freestanding Inpatient Rehabilitation Facility (IRF)Participants : 1078 patients admitted to inpatient rehabilitation facility between January and December 2020

Interventions: Fall risk, capacity for attention, and ability to transfer independently were used to stratify patients into 3 categories: high (red star), medium (yellow star), and low (green star). These were assessed and adjusted: upon admission, weekly, and after any fall. Patients were given a red star if unable to use the call light and wait for help or if scored 45 or more on Morse fall scale. Patients who could use the call light, wait for help, but unable to transfer independently, were given a yellow star. Those who could transfer independently were given a green star. Red star status triggered use of bed and seat belt alarms. Patients with yellow stars had self-releasing seat belts and cues for nursing to offer toileting assistance regularly. Green star patients did not have specific nursing interventions.

Main Outcome Measures: Total number of patient falls

Results: Data were collected for 12 months: 5 months prior to, and 7 months after intervention. Pre-intervention falls per 1000 patient days (M=11.6, SD=4.4) were higher than post-intervention days (M=9.3, SD=2.9), however, the difference was statistically nonsignificant, (p=0.296). Subcategorizing by admission diagnosis revealed decreased falls per 1000 patient days post-intervention amongst all diagnoses except spinal cord injury.Conclusions: Implementation of this fall prevention protocol resulted in a trend towards a decreased fall rate per 1000 patient days. The lack of statistical significance is important for the evaluation of the fall algorithm. Further variables contributing to the occurrence of falls should be investigated in future quality improvement projects, perhaps based on patients underlying diagnoses, which may prompt more specific interventions.

Level of Evidence: Level III

To cite this abstract in AMA style:

Roland JM, Kissling CR, Burris JE, Buchanan K, Gill B. Evaluation of a Novel Fall Prevention Program at Inpatient Rehabilitation Hospital [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/evaluation-of-a-novel-fall-prevention-program-at-inpatient-rehabilitation-hospital/. Accessed May 11, 2025.
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