Three-step program increases patient activation and engagement in hospital fall prevention efforts

Study in March 2020 issue of The Joint Commission Journal on Quality and Patient Safety Tuesday, February 25 2020

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(OAKBROOK TERRACE, Illinois, Feb. 25, 2020) – Hundreds of thousands of patients fall each year, and 30 to 50% of those patients sustain an injury.1,2 While falls are a major problem in health care settings, the risk of falling is even greater for hospitalized patients due to an unfamiliar environment, new medications and symptoms of acute illness. The number of patient falls and falls with injury can be reduced substantially with preventive measures.  

A new study, “Patient Activation Related to Fall Prevention: A Multisite Study,” in the March issue of The Joint Commission Journal on Quality and Patient Safety examines the role that patient activation played in the Fall TIPS (Tailoring Interventions for Patient Safety) program, a three-step fall prevention process, with patients and their families. The Fall TIPS process includes:

  1. Conducting a fall risk assessment
  2. Developing a personalized fall prevention plan
  3. Consistently following the plan, along with the use of universal fall precautions

Researchers surveyed a random sample of adult patients before and after implementation of Fall TIPS at three health care systems including Brigham and Women’s Hospital, Boston; Montefiore Medical Center, New York; and New York-Presbyterian Hospital, New York. The short form Patient Activation Measure (PAM-13) was adapted for fall prevention. The 13-item survey assessed a patient’s knowledge, skill and confidence in managing his or her own fall prevention, also known as “patient activation.”

Findings showed patient activation improved from preintervention to postintervention at all sites. Overall, the mean PAM score improved from 63.82 to 80.88 as patients with access to the Fall TIPS program were more activated and engaged in their fall prevention plan. 

“Formalizing strategies to facilitate and document hospital patient engagement in their own fall prevention approach has been a missing link in current evidence translation efforts to date,” note Terry P. Haines, PhD, and Anne-Marie Hill, PhD, in an accompanying editorial. “It will be fascinating to see results of future research along this path, and how broadly concepts related to patient activation can be applied to fall prevention both in hospitals and beyond.”

Also featured in the March issue:

For more information, visit The Joint Commission Journal on Quality and Patient Safety website.  


1Ash K, et al: Case control study of falls in the hospital setting. Journal of Gerontological Nursing, 1998;24:7-15. doi: 10.1111/j.1525-1497.2004.30387.
2Nursing Home Abuse Guide, Paul & Parkins Le; Sterling DA, O’Connor JA, Bonadies J. Geriatric falls: injury severity is high and disproportionate to mechanism. Journal of Trauma–Injury, Infection and Critical Care 2001;50(1):116–9. 

Note for editors
The article is “Patient Activation Related to Fall Prevention: A Multisite Study,” by Taylor L. Christiansen; Stuart Lipsitz, ScD; Maureen Scanlan, RN, MSN; Shao Ping Yu, MPH; Mary Ellen Lindros, RN, EdD; Wai Yin Leung, MS; Jason Adelman, MD, MS; David W. Bates, MD, MSc; and Patricia C. Dykes, PhD, MA, RN. The article appears in The Joint Commission Journal on Quality and Patient Safety, volume 46, number 3 (March 2020), published by Elsevier.

The Joint Commission Journal on Quality and Patient Safety
The Joint Commission Journal on Quality and Patient Safety (JQPS) is a peer-reviewed journal providing health care professionals with innovative thinking, strategies and practices in improving quality and safety in health care. JQPS is the official journal of The Joint Commission and Joint Commission Resources, Inc. Original case studies, program or project reports, reports of new methodologies or the new application of methodologies, research studies, and commentaries on issues and practices are all considered.