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    Ten ways to reduce hospital readmissions


    9. Preventing falls while encouraging mobility

    As DiGioia noted previously, falls are a common problem with joint replacements, and that's the case while the patient is in the hospital for the procedure and once they return home.

    At UPMC, the protocol is to get patients out of bed the night of their surgeries. Still, patients are counseled that they shouldn't try to get out of bed without a nurse or someone else right there with them, he says. "The night of surgery, we encourage them to always call [if they need help getting around]. That's an example where it's about patient education. We're doing rapid rehab, but we're educating patients on the potential problems if they fall," says DiGioia.

    The challenge is that many patients want to be independent, and they don't want to bother the nurse if they have to get up to go to the bathroom. "You hear that all the time, that they don't want to bother the nurses. But the nurses and the other staff here say very explicitly, 'No problem. Call us with those kinds of things.' It's about engaging patients in their own care," he says.

    UPMC uses bed alarms, signs about the risk of falling in patient rooms, and preoperative education pamphlets on the dangers associated with falls and the ways to prevent them. In addition, all staff members are trained on fall prevention, says Levison.

    The medical center has cut patient falls among joint replacement patients by more than 50% since these interventions were implemented. In 2012, before the falls prevention program started, there were 26 patient falls. In 2015, there were 12 patient falls, says Levison. He points out that, while the national fall rate is 3.92 falls per 1,000 patient days, UPMC's fall rate is 2.71.

    "We continue to monitor our falls very closely and the falls working group has begun to spread the best practices recognized within the orthopedic population across other service lines and throughout the entire hospital," he says.

    Aine Cryts is a writer based in Boston.

    Aine Cryts
    Aine Cryts is a freelancer based in Boston. She is a frequent contributor to Managed Healthcare Executive on topics such as diabetes, ...


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