Generalizability and Spread of an Evidenced-based Fall Prevention Toolkit: Fall TIPS (Tailoring Interventions for Patient Safety)

Brigham And Women'S Hospital, Boston MA

Investigators

Linked publications & trials

Abstract

ABSTRACT Falls are a major public health problem globally, and hospitalization increases the risk for falls. In the United States up to 1 million hospitalized patients fall annually and approximately 30% of falls result in injury. The Fall TIPS toolkit is an evidence-based fall prevention program that targets this high-risk group. It addresses documented physiological risk factors in this population and can be integrated into hospital-based Electronic Health Record (EHR) systems. Results from a randomized trial show that Fall TIPS significantly reduced falls and was particularly effective with older patients-- those at the greatest risk for falling (Dykes et al, 2010). Fall TIPS is currently being replicated in three large healthcare systems: Partners Healthcare (MA), Columbia Presbyterian (NY), and Montefiore (NY). It is ready for broad, diffusion to hospitals that can benefit from it. Based on our prior work and by leveraging these three ongoing large-scale implementations of Fall TIPS, we propose a translation and dissemination project to assess the potential public health impact of integrating Fall TIPS into hospitals with diverse patient populations and different EHR systems. We will conduct an initiation, process, and outcome evaluation of our program with respect to Reach (participation rate of patients), Effectiveness (reductions in fall and related-injury incidence), Adoption (participation rates of nurses and other healthcare providers), Implementation (degree to which intervention components are delivered as intended), and Maintenance (sustainability of the program over time). To better understand the translational process, we will also address issues such as program fidelity evaluation, facilitators/barriers, and cost. Outcomes from this dissemination study will increase understanding of the overall impact of the Fall TIPS program on providers and hospitalized patients. Study activities will both advance the development of Fall TIPS as a high quality, turnkey evidence based program and obtain new data on factors that facilitate the adoption, implementation, and maintenance of hospital- based fall prevention programs. The ultimate objective is to document and spread best practices related to implementing and sustaining an evidence-based fall prevention program that meets the AHRQ mission to make care safer and more affordable and the Healthy People 2020 goals of preventing unintentional injuries and reducing their consequences.