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• Filed under: Features, Cover Story, Quality

• Keywords: nurse, patient safety, rounds, teamwork, fall

Hospitalized Patient Fall Fatalities Eliminated

From: The eWire, 02.10.2010

by Richard Quinn

A concerted effort to reduce patient falls in Minnesota hospitals culminated last year as the Gopher State reported zero fatal falls—a result heavily attributed to hospitalist efforts.

A report last month from Minnesota health officials shows that no patients died from falls in 2009. It was the first fatality-free reporting period since the state began publicly disclosing adverse events six years ago. In 2008, 10 fall-related fatalities were reported in Minnesota hospitals.

"We went through our order sets and eliminated potentially unnecessary medications across the board," says Scott Tongen, MD, a hospitalist and medical director for quality at United Hospital in St. Paul. "And we challenged hospitalists to stop prescribing those … and at the same time we had to work with the nursing staff."

Dr. Tongen says his hospital, which is part of the Allina Hospitals and Clinics system, attacked the issue of falls by emphasizing hourly rounding by the nursing staff and collaborating with HM leaders. The state also developed Minnesota Falls Prevention, an award-winning Web site that shines light on the issue of preventable falls.

"I think one of the keys to success is empowering the nursing staff to work with the hospitalist service in partnership to accomplish this goal," says hospitalist James Young, MD, who works at United and is president of SHM's Minnesota chapter. "I know that at United, our nurses are far from mute and are not bashful about telling us when a patient is at risk. We are not bashful in educating them about why sleepers aren't a great idea for elderly patients. … It’s a team effort."