A Fall Prevention Quality Improvement Project in a Long Term Care Facility: Critical Analysis

Abstract

Falls are a main health burden among seniors, particularly in long term care facilities. A fall prevention quality improvement project was initiated in a geriatric care organization in Ontario, Canada. The purpose of this article is to critically analyze this quality improvement project for reducing fall incident rates by using a Six Sigma model. This quality improvement project consists of conducting a root cause analysis in post fall huddles, “Falling Star” program, and providing fall prevention education for residents and families. The strengths of this quality improvement process include the root cause analysis in post fall huddles and fall prevention education. Some limitations in this quality improvement process include insufficient collaboration with inter-professional team members and the exclusion of residents who are at fall risk, but had not fallen. Three recommendations are provided to increase the possibility of success for this project, including a monthly inter-professional fall safety meeting, the expansion of the “Falling Star” program for all residents at risk of falls, and staff education and training