News in brief - July 18, 2011

Hospital fall prevention programs ineffective, review says

Strategies commonly used to stop patient falls in the hospital are not working, said a comprehensive review of medical literature published in the July Journal of the American Academy of Orthopaedic Surgeons (www.ncbi.nlm.nih.gov/pubmed/21724919).

Fall-prevention programs that educate patients, assess their vision and provide walking aids, for example, do not reduce falls during a typical hospital stay, according to one study examined as part of the review. Such programs are more effective over the course of 20 or 30 days in long-term care, the evidence showed.

Federal law requires hospitals to implement fall-prevention programs, and the Centers for Medicare & Medicaid Services can deny payment to hospitals for providing follow-up care for a patient seriously injured in a hospital fall. Such policies are not justified, said Terry A. Clyburn, MD, an orthopedic surgeon and professor at the University of Texas Medical School at Houston, who co-wrote the literature review.

"Hospitals should educate patients and the families, use bedrails, keep beds low, keep floors dry and clear of clutter -- all the common sense things that can reduce the risk of falls," Dr. Clyburn said. "But we found no proof that falls in hospitals are, in fact, preventable. And if not, they should not be categorized as a preventable occurrence, and the burden shouldn't be borne by hospitals."

Back to top

Joint Commission offers palliative care certification

Most large hospitals now offer palliative care programs, but they vary in quality. Starting Sept. 1, the Joint Commission will begin offering a palliative care certification program for hospitals to demonstrate their level of quality.

Certification standards emphasize interdisciplinary leadership of the palliative care program, patient and family engagement, support from hospital leadership, adherence to evidence-based guidelines, and coordination of care and communication with hospice and other palliative care providers. More information about the certification is available at the Joint Commission website (www.jointcommission.org/certification/palliative_care.aspx).

Back to top