Preventing Falls Utilizing Remote Patient Observation

Research Objectives: To integrate best practices for patients who experienced an unwitnessed fall, the Falls Reduction Team at the University of Vermont Medical Center Inpatient Rehabilitation investigated the effect of Remote Patient Observation (RPO) video monitoring on the rate of repeat falls. This presentation describes a Quality Improvement project initiated after a patient experienced an unwitnessed fall, followed by a subsequent fall with injury.

Design: As a result of Root Cause Analysis, we instituted a process that any patient with an unwitnessed fall be put on Remote Patient Observation (RPO) for at least 24 hours. RPO is an effective video monitoring tool with evidence that it helps prevent falls. The goals of this before-after intervention trial were to enable closer assessment of the patient's ability to call appropriately, create opportunities to promote patient education, determine whether the patient had behaviors putting them at greater risk for fall, and produce safer patient outcomes.

Setting: The University of Vermont Medical Center Inpatient Rehabilitation program is a 20-bed hospital unit serving a patient population aged 18 and over.

Participants: Any patient who experienced an unwitnessed fall was placed on RPO for at least 24 hours.

Interventions: We instituted RPO intervention on September 15, 2022. Overall falls and repeat falls were compiled for this study for 19.5 months preceding and subsequent to this intervention, from February 1, 2021 through April 30, 2024.

Main Outcome Measures: The primary study outcome measured was the rate of repeat patient falls following the implementation of RPO. A secondary measured outcome was overall fall rates before and after the intervention.

Results: Rates of repeat falls following an unwitnessed initial fall decreased from 11 out of 34 (32.4%) pre-intervention, to 3 repeat falls out of 37 unwitnessed falls (8.1%) post-intervention. However, the overall rate of falls did not decrease significantly. A two-sample t-test revealed that there was no statistically significant difference in mean rates of falls (per 1000 occupied bed-days) when comparing the overall falls preceding (M = 7.062, SD =3.753) and following (M = 7.309, SD = 3.191) the RPO intervention t(38) = -0.224, p = 0.824.

Conclusions: While our total data set is still small, the trend is encouraging, and our nursing-led Falls Reduction Team will continue tracking the outcome of RPO on monthly repeat fall rates, using this data to both inform and improve patient safety outcomes.

Author(s) Disclosures: The authors declare that they have no relevant or material financial interests that relate to the research described in this paper.