Decline in falls and broken hips a success story for health

Decline in falls and broken hips a success story for New Zealand health care

Embargoed to 12:01 am 2 December 2016

The Health Quality & Safety Commission is celebrating the success of New Zealand public hospitals in reducing the number of in-hospital falls that result in a broken hip. New Zealand appears to be the first country to achieve this on a national scale.

A paper published in the New Zealand Medical Journal today highlights a sector-wide commitment to preventing harm and in reducing the number of falls resulting in serious harm in New Zealand.

This includes a 40 percent reduction in falls occurring in public hospitals which resulted in a broken hip since December 2014. The number of falls in our public hospitals leading to a hip fracture has fallen for six consecutive quarters.

Many international initiatives to reduce this kind of harm from falls have not succeeded.

The Commission’s clinical lead for reducing harm from falls, Sandy Blake, says these results are important because hip fracture is the most common serious fall-related injury in those over 80 years old.

‘Only half of those who survive a hip fracture will walk unaided again, and many will not regain their former degree of mobility.

‘Between 10 and 20 percent will be admitted to residential care as a result of the fracture. Very sadly, 27 percent of those over 80 will die within a year of their hip fracture.’

Contributing to this result, the Commission has recorded an increase in the number of older patients assessed for their risk of falls in NZ hospitals from 77 percent in the first quarter of 2013 to 91 percent in June 2016.

Of those patients who were found to be at risk, 95 percent were given an individualised care plan in June 2016, compared to 77 percent in the first quarter of 2013.

The paper is published alongside an editorial by Dr Frances Healey, deputy director of patient safety insight at NHS Improvement in the United Kingdom. Dr Healey is an international expert in patient safety and falls research and says the Commission’s results are a world-first.

She says the Commission’s Reducing Harm from Falls programme is the first in the world to describe credible reductions on a national scale in the most serious type of harm – fractured hips from falls in hospitals.

‘These fractures lead to long-term loss of independence for most patients who experience them, and are followed by death within weeks or months for too many.’

The Commission’s latest Learning from adverse events report also shows a reduction in the total number of in-hospital falls reported to the Commission.

When the Commission was established in 2010, voluntary reporting of in-hospital falls accounted for 51 percent of all reported adverse events. The number of falls reported rose by 50 percent each year from 2007–11. However, in 2015–16 the number of falls reported fell to 237, compared to 277 in 2014–15, a 14 percent reduction. This is the first reduction since 2009–10.

‘This reduction has occurred because of support provided by the Commission to the sector and the efforts of those working in our hospitals to prevent falls from occurring,’ says Sandy Blake.

The Commission is now building on this approach and continuing the work detailed in the paper with the Ministry of Health and ACC.

The NZMJ article is available to view here. Frances Healey’s editorial is available to view here.

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