The case is reported of an open injury of the right arm sustained during a parachute jump. The fracture was managed in the usual way with wound debridement, wound irrigation, skeletal stabilisation, and reconstruction of the soft tissues. Good shoulder and elbow function were achieved. The combined effort of an orthopaedic trauma surgeon and plastic surgeon is essential to improve outcomes in such cases.

Background: Inpatient falls with harm have severe implications on patients and the health care system. Purpose: We implemented a zero harm approach to falls prevention, which aimed to reduce falls with injury by 25% within 1 year. Methods: We implemented a multifaceted and multidisciplinary quality improvement falls prevention strategy that included facilitating organization-wide education, adopting the Morse Fall Risk Assessment tool, displaying real-time unit-specific falls rates, and implementing a transparent root-cause analysis process after falls. Our outcome measure was falls with injury per 1000 patient-days. Results: We observed a decrease in the rate of patient falls with injury from 2.03 (baseline period) to 1.12 (1 year later) per 1000 patient-days. We also observed increases in awareness around falls prevention and patient safety incident reporting. Conclusions: Our zero harm approach reduced falls with injury while improving our patient safety culture.

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