• Ava D Lancaster, Annette Ayers, Brenda Belbot, Virginia Goldner, Linda Kress, Donna Stanton, Polly Jones, and Lora Sparkman.
• Saint Thomas Hospital, Nashville, Tennessee, USA. DLANCAST@stthomas.org
• Jt Comm J Qual Patient Saf. 2007 Jul 1;33(7):367-75.

BackgroundFor Ascension Health's Healthcare That Is Safe strategy, eight hospitals served as alpha sites in the program to prevent falls and eliminate falls with injury.MethodsThe alpha sites implemented four key strategies: (1) assessment and re-assessment of patient risk factors for falls, (2) visual identification of patients at high risk, (3) communication of patient fall risk status, and (4) education of patients, families, and staff about fall prevention.ResultsThe recommendations of the alpha initiative spread rapidly throughout Ascension Health and preceded measurement of the fall ratio. Even so, a 9.9% systemwide reduction in acute care fall rates from January to October 2006 was observed, and the average rate of falls with serious injury was less than 0.10 per 1,000 patient days. Compared with national rates, falls with serious injury at Ascension Health were less than 10% of the expected rate.DiscussionAlthough it is not possible to prevent all falls in acute care facilities, decreasing the number of falls and the risk of serious injury from falls is possible. Key steps caregivers can take to prevent falls and fall injuries include establishing a trusting relationship with patients and their significant others; frequently reorienting patients to their environments, reminding those at high risk of falls not to get out of bed without help; checking on patients frequently and keeping their personal articles within reach; and protecting patients from falls at all entry points into the health care system.

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