A new approach helps Atrium Health to reduce falls – and the associated costs
Atrium Health’s approach to fall prevention was previously inadequate and did not adequately protect the safety of hospital patients.
THE PROBLEM
The healthcare system’s previous fall prevention technology lacked the discretion needed to obtain specific details of patient data. Although Atrium staff had access to raw figures, the information was not sufficiently insightful to allow staff to delve into crucial aspects, such as time of day and specific days of the week, without having to resort to extensive manual efforts.
This limitation hindered the staff’s ability to conduct thorough analysis and identify patterns efficiently.
PROPOSAL
“The urgent need for a more refined approach was especially evident from a nursing perspective, given that falls are a major problem in healthcare,” said Robert Rose, market leader of nursing for Atrium Health’s central division. “Our hospitals also adhered to magnet indicators, and the new technology we implemented has proven instrumental in developing a robust fall prevention plan.
“The advanced features of the new fall prevention technology allowed us to overcome the challenges we previously faced,” he continued. “With improved monitoring and measurement capabilities, we are better equipped to understand the dynamics of falls, identify trends and implement targeted interventions. The technology has not only streamlined our processes, but has also served as a valuable tool in our efforts to reduce reduce falls and improve overall patient safety.”
“Embedding evidence and links directly into the workflow ensures important information is not overlooked.”
Dawn Ross, DPN, RN-BC, Atrium Health
In seeking out the new technology, the emphasis was on evaluating outcomes and understanding whether technology could actually improve outcomes, rather than being adopted just for the sake of having it. Employees seeing other facilities where the technology had already been implemented allowed them to analyze the consequences of falls in that context.
“This assessment was critical in determining the technology’s impact on outcomes,” Rose said. “It is important to adopt technology not just for technology’s sake, but to ensure that it actually contributes to improving outcomes. The ability to assess outcomes and base them on the experiences of other facilities has influenced the decision to implement the fall prevention technology. We went through a very thorough evaluation of the technology before deciding to implement it.
“There were certainly some challenges associated with the implementation as it was a significant change for the nursing teams and colleagues involved,” he continued. “Fall prevention technology introduced a paradigm shift that required adaptation from healthcare professionals who were unaccustomed to such innovations.”
The fall prevention technology proposal was based on assessing outcomes, learning from existing implementations, and ensuring that the technology provided specific interventions to reduce falls. The decision to implement this technology was based not only on the desire for the technology, but also on a thorough evaluation of its impact and relevance in improving patient outcomes.
“The implementation process involved navigating the challenges associated with change, especially for the nursing teams involved,” said Rose.
MEETING THE CHALLENGE
Atrium Health was faced with challenges in fall prevention, which prompted a thorough review of available resources and consultation with various vendors. Ultimately, the Hester Davis Falls Program had been chosen.
At the time, there was no collaboration between Hester Davis and Atrium Health’s EHR supplier. To address this, a large multidisciplinary team was put together, consisting of people from different departments involved in fall prevention.
Since this first construction, Atrium has switched to Epic for its EHR and a partnership is in place, making construction much easier for staff.
“The first step was to hire an IT analyst and a clinical informatics specialist,” said Dawn Ross, DPN, RN-BC, vice president and chief clinical informatics officer at Atrium Health. “Then, individuals from nursing, fall team, administration, nutrition, transportation, therapies, facilities, pharmacy, supply chain and respiratory were involved in the collaborative effort.
“Due to the lack of a pre-existing partnership, an extensive build was performed, followed by testing and workflow analysis,” she continued. “The team assessed how the technology supported different workflows and strategically leveraged the multidisciplinary team to ensure comprehensive coverage.”
Strikingly, the Hester Davis program went beyond identifying fall risks to providing interventions related to those risks. The organization invested in chair alarms, bed alarms and mats to increase patient safety. During implementation, the team identified the importance of the proximity and accessibility of these tools.
“The data-driven approach enabled by the technology provides a deeper understanding of when and how falls occur, leading to valuable insights and informed interventions.”
Robert Rose, Atrium Health
Initially stored in the central stockpile and later in a supply room, the resources eventually found their place directly in the patient rooms, making them immediately available to nurses for timely intervention.
“A unique aspect of the waterfall management program was the associated analysis and program functions,” Ross explains. “The organization implemented a ‘fall huddle’ form, where information was submitted electronically directly from the EHR. The link to the fall debrief was embedded in the Epic workflow, streamlining the process for healthcare professionals.
“The integration of these tools, interventions and analytics has collectively helped achieve positive fall prevention outcomes across the organization,” she added.
RESULTS
The technology platform has seen significant success in reducing falls and preventing falls with injuries since its implementation in April 2022. The fall rate, which initially averaged around 3.5, has dropped to just 2.22 and is currently around 3.1.
“This demonstrates a positive trend and highlights the effectiveness of the technology in minimizing falls,” Rose reported. “In addition, there has been a noticeable decrease in the number of falls resulting in injuries, which underlines the main aim of the initiative. The implemented technology has helped prevent falls and injuries, which is crucial in healthcare.
“The data-driven approach enabled by the technology provides a deeper understanding of when and how falls occur, leading to valuable insights and informed interventions,” he continued. “Additionally, the financial impact is significant, with an estimated cost savings of approximately $500,000 based on literature-related decreases.”
The overall positive impact on patient safety, nursing care and cost savings underlines the successful results achieved through the implementation of this technology, he added.
ADVICE FOR OTHERS
“An important lesson we learned is the importance of using foam mats,” Ross advised. “These mats have proven to be indispensable in preventing injuries resulting from falls. They may seem like a simple addition, but their impact on patient safety is significant.
“Collaboration with EHR vendors is another critical aspect,” she continued. “Integrating fall prevention technology with the EHR system increases its effectiveness. The EHR vendor can play a complementary role, complementing the technology and ensuring that relevant information is seamlessly connected. This integration not only streamlines the workflow for healthcare providers , but also strengthens the completion of necessary interventions.”
Additionally, it is critical to group information within the EHR to avoid nurses having to navigate multiple platforms, she added.
“Embedding evidence and links directly into the workflow ensures important information is not overlooked,” she says. “We have taken the extra step of including fall prevention documentation in our required shift documentation, emphasizing the importance of reassessment in preventing falls.
“An intuitive but valuable lesson we have learned is having computers at the bedside,” she concluded. “This not only facilitates real-time documentation, but also engages patients in the process. Explaining to patients what is being documented and why creates a sense of ownership, making them active participants in the fall prevention team.”
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