Authors: (including presenting author): :
Kwok CC(1), Leung MLG(1), Lam YF(1), Ng ML(1)
Affiliation: :
(1) Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Keyword 1: :
fall prevention
Keyword 2: :
SMART approach
Keyword 3: :
staff engagement
Keyword 4: :
team commitment
Introduction: :
Ensuring patient safety is a key focus in healthcare, particularly in minimizing fall incidents in inpatient settings. This initiative aims to strengthen safety measures for fall prevention in the Department of Medicine.
Objectives: :
The Patient Fall Prevention Team of the Department of Medicine launched a targeted initiative to address alarming fall rates in three main areas: 1) adopting electronic means to manage fall prevention data and information, 2) implementing self-evaluations and rectifications during safety round, and 3) providing structured staff education.
Methodology: :
A comprehensive care bundle was established since January 2024, which includes:
1. Smart Data Management: Innovative strategies were adopted to manage data and information related to fall prevention. This included a paperless patrol round record and an online submission system for monthly compliance surveys on fall preventive measures initiated on January 1, 2024. Over 460 responses were collected. This modern initiative, utilizing smart strategies, is user-friendly and has reduced the workload of frontline nurses by cutting down on paper use and filing of records, while also facilitating more effective data analysis.
2. Implementation of the Plan-Do-Check-Act (PDCA) Cycle: The PDCA cycle was piloted in six inpatient wards facing increased fall incidents and severity, resulting in a significant reduction of fall incidents by 53% when comparing the data three months before and after the PDCA cycle was conducted.
3. Annual Fall Drills and Educational Webinars: Annual fall drills were initiated in 2024 for patients, staff, and visitors, with increased participation using a livestream format; a total of 172 staff members (25% of the department's nursing and supporting staff) participated. Additionally, two educational webinars were held each year for nurses and supporting staff, providing updates on fall prevention practices and guidelines, with 528 participants recorded since 2024.
Result & Outcome: :
The established care bundle significantly decreased the inpatient fall rate from 0.41 to 0.38 between the upper and lower halves of 2025. The majority of fall incidents in 2025 involved self-evaluation and rectification, empowering staff to take ownership of safety practices by collaborating with the team to identify root causes and develop tailored solutions for the unique challenges faced by each ward. This initiative will facilitate the development of an online submission system for fall incident analysis reports, enabling systematic and time-saving data analysis.
