Reducing Patient Falls with Evidence-based Tools
Patricia Dykes, Ph.D., R.N.
Harvard Medical School, Boston, MA
“Patient falls can result in traumatic and costly outcomes. With AHRQ funding, I’ve been able to provide hospitals and primary care practices with falls prevention tools that can be incorporated into routine care.”
Falls are a major public health problem. In the United States, up to a million hospitalized patients fall annually; approximately 30 percent of those falls result in injury. Falls and related injuries also are a concern for older adults living in the community.
Patricia Dykes, Ph.D., R.N., associate professor of medicine at Harvard Medical School and research program director at Brigham and Women's Hospital’s Center for Patient Safety, Research, and Practice in Boston, has dedicated her career to developing and disseminating evidence-based resources to reduce patient falls. With funding from AHRQ, Dr. Dykes evaluated the benefits of a falls prevention toolkit for hospitals and created software that helps primary care physicians develop falls prevention strategies. Through these efforts, she is helping prevent patient falls in both inpatient and outpatient care settings.
Dr. Dykes was awarded an AHRQ grant in 2017 to evaluate the FallTIPS (Tailoring Interventions for Patient Safety) toolkit, which she had helped to develop through an AHRQ Patient Safety Learning Lab. Her assessment found that the evidence-based toolkit reduced hospital falls by 15 percent and fall-related injuries by 34%. To use it, clinicians determine a hospital patient’s risk of falling and develop a tailored falls prevention plan. Then hospital staff talk to patients as part of routine care at the bedside about their risk for falling, using digital posters connected to electronic health records to guide the conversation. They also place laminated posters in patients’ rooms to engage patients across health literacy levels.
This initial study evaluated use of the toolkit in three large healthcare systems in Massachusetts and New York. It helped document and deploy best practices for implementing and sustaining an evidence-based falls prevention program in hospitals.
“By funding dissemination, AHRQ helped make FallTIPS the standard resource for falls prevention around the world. The tool has also been adopted by the U.S. Departments of Veteran’s Affairs and Defense,” said Dr. Dykes.
In 2020, Dr. Dykes expanded her falls prevention efforts to primary care. She received a two-year AHRQ grant to develop and provide primary care clinicians with standards-based software tools to prevent patient falls, as “fall and injury incidence is a persistent problem among community dwellers over the age of 65,” Dr. Dykes noted. Her ASPIRE clinical decision support software quickly and easily guides clinicians to the most feasible falls prevention strategies for a community-based patient using three individual risk factors: mobility limitations; medications that can increase the risk of falling; and osteoporosis. The software also helps clinicians engage patients in their own falls prevention decision-making. The initial part of this study included interviews with primary care clinicians to find out if they liked the tool and whether they would use it. Dr. Dykes plans to seek additional funding to conduct a clinical trial to determine the tool’s success in reducing falls.
Dr. Dykes is a Fellow of the American Academy of Nursing, the American College of Medical Informatics, and the International Academy of Health Sciences Informatics. She is a member of the American Medical Informatics Association, American Nurses Association, International Medical Informatics Association, and New England Informatics Consortium. She also is a member of the nursing honor society, Sigma Theta Tau International, and is a Fellow in their International Nurse Research Hall of Fame.
Related AHRQ Resources
- AHRQ’s Safety Program for Nursing Homes: On-Time Falls Prevention
- Falls TIPS: A Patient-Centered Fall Prevention Toolkit
- Preventing Falls in Hospitals
- The Falls Management Program: A Quality Improvement Initiative for Nursing Facilities
Principal Investigator: Patricia Dykes, Ph.D., R.N.
Institution: Harvard Medical School, Boston, MA
Grantee Since: 2017
Type of Grant: Various
Consistent with its mission, AHRQ provides a broad range of extramural research grants and contracts, research training, conference grants, and intramural research activities. AHRQ is committed to fostering the next generation of health services researchers who can focus on some of the most important challenges facing our Nation's health care system.
To learn more about AHRQ's Research Education and Training Programs, please visit https://www.ahrq.gov/training.