Terry Haines completed his Ph.D. at the age of 26 years from the University of Melbourne in which he conducted the world’s first randomized trial to demonstrate that falls in hospitals could be prevented. He is the director of the Allied Health Research Unit at Monash Health &Monash University, director of Hospital Falls Prevention Solutions Pty Ltd, is supported by a career development fellowship from the National Health and Medical Research Council, and is president of the Australia New Zealand Falls Prevention Society. He has published over 130 peer-reviewed papers.
Accidental falls are the most common adverse event occurring in many hospitals. Large trials of interventions to prevent falls in hospitals have been undertaken over the past decade but paint a confusing picture of what is and is not effective. Further, many trials are limited by use of incident reports in isolation to capture falls data, which is known to underestimate falls by between 25-50%. This presentation reviews seminal papers in the field of falls prevention in hospitals before focusing on use of a behavioral / risk taking model to understand falls and their prevention. Four studies will be focused upon. First, a qualitative study of hospital inpatients from medical and rehabilitation wards (n = 16), their informal caregivers (n = 8), and health professionals (n = 33). This study developed a framework for understanding why older hospital patients take risks that may lead to falls. Second, a randomized controlled trial amongst hospital inpatients from medical and rehabilitation wards (n=1206) examining the effect of a patient education program for the prevention of falls. Third, a cost-effectiveness study of this patient education program. Fourth, a stepped-wedge cluster randomized trial of a state-wide roll-out of this patient education program across rehabilitation units (n=8) in Western Australia over a 12 month period. The behavioral / risk taking model challenges the established and widely applied multifactorial falls risk factor approach, and indicates that we may have been falling for misconceptions when using the established multifactorial risk factor model in the hospital setting.