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Becoming fall-safe: a framework for reducing inpatient falls

12 November 2020
Volume 29 · Issue 20


This article describes a 10-year programme of work that has reduced inpatient falls rate by 46% and how this improvement has been sustained. The methodology applied in this initiative has forced one Trust to challenge expectations about the inevitability of patient falls in hospital. This initiative has resulted in approximately 568 fewer falls each year. Based on costings from NHS Improvement, the estimated 5108 fewer falls between 2011 and 2019 have saved the Trust £13.3 million.

Inpatient falls are the most commonly reported patient safety incidents in the NHS. The most recent Organisation Patient Safety Incident Reports (OPSIR) workbooks based on data submitted to the National Reporting and Learning System (NRLS) covering the period April 2018 to March 2019 reported 228 503 patient accidents in acute (non-specialist) hospitals in England and Wales. The vast majority of these patient accidents would be patient falls and the number suggest more than 600 patients fall every day (NHS Improvement, 2020a; 2020b). With statistics like these, it is easy to see why inpatient falls are often viewed as ubiquitous and inevitable in hospitals. All falls, even those that do not result in injury, can cause patients and their families to feel anxious and distressed. For those who are frail, minor injuries from a fall can affect physical function, resulting in reduced mobility and undermining patient confidence and independence.

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