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Breakthroughs Magazine

Notable Achievements

Landing on its feet: hospital reduces patient falls

After accumulating a higher-than-average number of patient falls in recent years, Our Lady of Lourdes Hospital in Pasco, Wash., was able to land on its feet last year with the help of Battelle engineers at Pacific Northwest National Laboratory.

Using a risk assessment analysis facilitated by PNNL researchers, the hospital was able to cut patient falls by an astonishing 42 percent over just 15 months.

"There are so few engineers in the medical field that hospital risk management staff asked for our help in meeting new patient safety standards set by the hospital accrediting organization, specifically on slips and falls analysis," said PNNL's Garill Coles, who led the risk assessment team.

Coles mentored Lourdes staff in the use of a common engineering tool in risk assessment to examine the policy, procedures and practices related to patient fall risk. He asked hospital management to consider how it could fail and what the consequences of that failure would be.

They then identified the safeguards in the current process, such as double checking patient charts to make sure patients at risk of falling were properly identified when they were first admitted to the hospital. An algorithm was used to score the vulnerability in the system, and categorized those failure modes as high, medium or low risk.

In response to the study, Lourdes now implements an updated patient assessment of fall risk upon the patient's arrival at the hospital, holds staff refresher courses, uses bed alarm systems, color-codes charts of patients at risk of falling and improved the Patient Fall Risk Care Plan process to allow hospital staff to provide the proper level of care to patients.

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