March 11, 2013 - A leading national organization that recommends health care performance standards has endorsed two quality measures developed by the American Nurses Association’s (ANA) National Database of Nursing Quality Indicators® (NDNQI®) to improve patient safety in hospitals--patient fall rate and patient falls with injury.
Patient falls are among the numerous performance measures reported by NDNQI, the nation’s most comprehensive database of nursing performance indicators. The database is used to evaluate and improve the quality of nursing care and associated patient outcomes in hospitals. The National Quality Forum’s (NQF) endorsement of these falls measures recognizes registered nurses’ crucial contributions to patient outcomes, since nurses often spend the most time with patients and implement prevention strategies.
The Partnership for Patients, a coalition of government, hospitals, employers, providers, and patient advocacy groups whose goal is to make hospital care safer, more reliable, and less costly, also understands nurses’ key role in preventing falls. ANA is working closely with the Partnership to reduce falls and injuries from falls.
“The National Quality Forum endorsement gives credence to the value nurses provide, in human and economic terms,” said ANA President Karen A. Daley, PhD, RN, FAAN. “Patient falls cause injury and suffering, and inevitably complicate and extend care.”
Falls are a leading driver of health care costs, especially for the elderly. What’s more, Medicare and Medicaid do not reimburse hospitals for costs associated with injuries from inpatient falls, essentially increasing unreimbursed hospital health care costs.
Researchers writing in the Clinics in Geriatric Medicine found that up to half of falls in hospitals result in some injury. One fall without serious injury increases costs for a hospital by about $3,500, while patients with two or more falls without serious injury cost an additional $16,500. Patients who suffered one or more falls with at least one serious injury cost an additional $27,000.
Inside and outside of health care settings, fall-related injuries for people ages 65-and-over are costly. By 2020, more than four million older Americans are projected to incur a fall with injury annually, with a total cost of about $47 billion (adjusted to 2010 dollars).
The rate of injurious patient falls at the more than 1,900 hospitals that collect and submit data to NDNQI dropped by 5.4 percent from 2009 to 2011, as facilities identified falls as a problem area and implemented strategies to reduce them. Hospitals that participate in NDNQI use the performance data to compare patient outcomes to similar units in other hospitals and determine where new strategies are needed to improve results.
NQF is a nonprofit organization that builds consensus on national priorities and goals for performance improvement and endorses national consensus standards for measuring and publicly reporting on performance. ANA is a member of NQF and participates in various roles in NQF’s evaluation and endorsement process for quality standards.