Hospital falls prevention maturity model: a framework for advancing safety practices

Patient safety is a critical component of healthcare quality. Hospital falls are a frequent and harmful event, with multifactorial causes and significant consequences for both patients and healthcare systems. Despite the widespread use of incident reporting systems (IRS) as a risk management tool, challenges such as underreporting, poor data quality, and fragmented analytical approaches persist, limiting their effectiveness. To address these gaps, this study proposes a theoretical maturity model (MM).

The proposed MM was developed based on a systematic literature review (SLR), conducted according to Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. An inductive thematic analysis identified core capabilities required for effective hospital falls management. These were integrated into a conceptual MM supported by a data collection instrument and a fuzzy multi-criteria decision-making (MCDM) approach.

Based on the synthesis of the SLR findings, a conceptual MM was developed to assess healthcare organizations' maturity levels in hospital fall management. The model enables the identification of organizational gaps, prioritization of improvement actions and guidance on decisions aligned with patient safety objectives. It includes a data collection instrument and applies a fuzzy MCDM approach to aggregate information. An illustrative example demonstrates the model's potential applicability and functionality.

This theoretical MM offers a structured foundation for future research, tool development and practical applications in clinical settings. By integrating fall-related factors, reporting quality and system characteristics, the model promotes a comprehensive and strategic approach to fall management. It moves beyond isolated interventions and supports the coordinated enhancement of patient safety across healthcare institutions.