Falls and Frailty: Finding Who’s at Risk and Keeping Them Safe

Katrina Dupins

Falling is the No. 1 reason for hospitalization of those 65 years old or older. About one third of those over age 65 will fall annually. Half the people over 80 will fall, according to the Centers for Disease Control and Prevention.

Falls are the most common and costly of all adverse events reported in hospitals. In 2010, the number of falls and injuries related to falls at UAMS caught the attention of Amy Hester, R.N., clinical services manager and Dees Davis, R.N., advanced practice partner.

“We began looking at the way we assess falls and the risk each of our patients had for falling,” Davis said. “We realized that’s what we needed to change. We needed a better tool to be able to pick out the patients who were at risk to fall.”

Their research produced a risk assessment tool to identify a patient’s risk of falling and comprehensive approach to care to prevent the falls from occurring. Known as the Hester-Davis scale, the model reduced fall rates at UAMS by 11 percent. Fall-related injuries dropped 60 percent and have continued to decline – saving the hospital $1.27 million in falls-related costs and $330,000 in savings as a result of the elimination of patient sitters for falls management. A recent article in Becker’s Hospital review ranked UAMS at the top of the list for hospitals that saved money in innovative ways.

“When we started, we weren’t looking to create some big marketable product on the back end,” Hester said, “We were looking to create a better way to predict fall risk to better care for our patients.”

The Hester-Davis Scale is a part of HD Nursing, a business they began through UAMS BioVentures as a vehicle to take their work to the health care industry. While the Hester-Davis scale has been successful for UAMS and many other hospitals around the country, Hester and Davis are looking to reduce falls and injury even further.

“We don’t want to just keep patients safe while they’re in the hospital,” Hester said. “We want to lower their risk to fall as much as we can before they go home so that they can be safe after they’re discharged.”

“We were looking to create a better way to predict fall risk to better care for our patients.”
HD Nursing is working on a new prediction model — the first of its kind — that will identify which patients are most likely to injure themselves if they were to fall.

Learning more about who is at risk for injury and who is not will help clinicians make evidence-based decisions about treatment and care.

The fall management and injury management program HD Nursing has available now is for hospitals, but Hester and Davis expect the new model for injury prediction to be offered to the community and across care settings.

“This new model can be used in homes, assisted living facilities and anywhere else,” Hester said. “We’re working very hard with leading industry vendors to develop a methodology to bring fall and injury prevention to people in the community in a meaningful way.”

They hope to make the model available through smartphone applications, kiosks in the community and health care providers.