The Baptist Health High Risk Falls Assessment: a methodological study

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Clinical Assessment Tools

Background:

• Falls in healthcare settings lead to increased patient morbidity, mortality, and costs.
• A psychometrically sound fall risk assessment is crucial for effective patient safety interventions.
• The Baptist Health High Risk Falls Assessment (BHHRFA) was developed to address this need.

Purpose of the Study:

• To evaluate the psychometric properties of the BHHRFA.
• To determine the clinical utility and performance of the BHHRFA in diverse acute care environments.

Main Methods:

• A multisite study involving 241,599 adult inpatients across medical-surgical, rehabilitation, psychiatric, and critical care units.
• Calculation of sensitivity, specificity, and diagnostic odds ratios (DORs) to assess the BHHRFA's accuracy.
• Evaluation of clinical usefulness based on assessment performance time.

Main Results:

• The BHHRFA exhibited psychometric properties within desirable ranges across all sites and patient populations.
• Sensitivity ranged from 0.64-1.00, specificity from 0.50-0.70, and DOR from 4.73-7.0.
• One site showed high sensitivity (0.84) but lower specificity (0.37), indicating potential for site-specific calibration.

Conclusions:

• The BHHRFA is a clinically useful tool for identifying fall risk in adult inpatients.
• The assessment demonstrates reliable psychometric properties across various acute care settings.
• Further evaluation may be beneficial for optimizing site-specific performance.