Reducing the cost of inpatient falls: An ERM perspective

Traditional fall prevention activities are not effective in preventing inpatient falls or injuries from falls. A knowledge of the five steps of Enterprise Risk Management (ERM) provides risk professionals with opportunities to apply them on an organization-wide basis to existing risks. The authors demonstrate how to apply the five steps of ERM to the common risk/patient safety issue of fall injury prevention. The authors completed a comprehensive literature review and identified predictors of injuries from falls. A comprehensive framework emerged which assists in predicting and preventing falls with injury in the inpatient setting. In combination of two or more, the following have been shown to predict injuries after falls: the use of oral anticoagulants, being born female, dementia, polypharmacy, the use of Fall Risk Increasing Drugs, urologic co-morbidities, and HIV positive status. When the ERM Process is applied to injury from falls, a Strategic Risk Response is created which assists the risk professional with application of the ERM process. Shifting focus from fall prevention to fall injury prevention, with the application of the ERM Process, creates value for the patient and the organization, and contributes to program success and sustainability.