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Considerations across multiple stakeholder groups when implementing fall prevention programs in the acute hospital

Charlotte McLennan1,2, Catherine Sherrington1,2, Wendy Tilden3

  • 1School of Public Health, Faculty of Medicine and Health, The University of Sydney, A27 Fisher Rd, New South Wales, 2050, Australia.

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Summary

Hospital fall prevention is a priority, but implementation is hindered by unclear responsibilities and disempowerment. Shared responsibility among staff, patients, and families is key to effective fall prevention strategies.

Keywords:
accidental fallsageinghospitalsinpatientsolder peoplepatient safetyqualitative research

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Area of Science:

  • Healthcare quality and safety
  • Patient safety research
  • Hospital management

Background:

  • Hospital falls are a significant international patient safety concern, incurring substantial costs.
  • Despite evidence supporting multifactorial programs and education, effective implementation of fall prevention strategies in hospitals remains a challenge.
  • Understanding stakeholder perspectives is crucial for successful implementation of fall prevention initiatives.

Purpose of the Study:

  • To explore the perspectives of clinicians, patients, and families on implementing fall prevention programs in acute hospital settings.
  • To identify barriers and facilitators to the effective implementation of hospital fall prevention strategies.

Main Methods:

  • Qualitative study involving semi-structured interviews and focus groups with 50 participants (clinicians, patients, families) across two acute public hospitals.
  • Data analysis employed an inductive thematic approach to identify key themes.

Main Results:

  • Three primary themes emerged: 'Fall prevention is a priority, but whose?' highlighting unclear accountability; 'Disempowered stakeholders' reflecting frustration with current practices; and 'Shared responsibility may be a solution' indicating optimism for collective action.
  • Participants recognized falls as a priority but lacked a clear sense of personal responsibility.
  • Feelings of powerlessness and frustration were common among stakeholders regarding fall prevention efforts.

Conclusions:

  • While hospital fall prevention is acknowledged as a priority, challenges in role perception, competing demands, workforce pressures, and disempowerment contribute to its neglect.
  • Enhancing a sense of shared responsibility across all stakeholders—including different disciplines, organizational levels, patients, and families—is essential for overcoming implementation barriers and improving fall prevention outcomes.