Patient Activation Related to Fall Prevention: A Multisite Study

Taylor L Christiansen, Stuart Lipsitz, Maureen Scanlan, Shao Ping Yu, Mary Ellen Lindros, Wai Yin Leung, Jason Adelman, David W Bates, Patricia C Dykes

PMID: 31948814
DOI: 10.1016/j.jcjq.2019.11.010

Abstract

Background: Falls are a major problem in hospitals. The fall prevention program Fall TIPS (Tailoring Interventions for Patient Safety) has been shown to be effective in preventing inpatient falls and related injuries. The purpose of this study was to examine the impact of the Fall TIPS program on patient activation related to fall prevention.

Methods: Patient activation was measured by surveying a random sample of adult patients before and after implementation of Fall TIPS at three health care systems. Researchers used the short form Patient Activation Measure (PAM-13) adapted for fall prevention. This 13-item survey assesses a patient's knowledge, skill, and confidence in managing his or her fall prevention. Patients (N = 343) were surveyed on medical units at Brigham and Women's Hospital (BWH), Montefiore Medical Center (MMC), and New York-Presbyterian (NYP) Hospital. Statistical analysis using the robust t-test was done to compare patient activation in the preintervention and postintervention groups.

Results: Patient activation improved from preintervention to postintervention at all sites (BWH, p < 0.0001; NYP, p = 0.0373; MMC, p < 0.0001). Overall, the mean PAM score improved from 63.82 (standard deviation [SD] ± 17.35) to 80.88 (SD ± 17.48), p < 0.0001.

Conclusion: Patients with access to the Fall TIPS program are more activated and engaged in their fall prevention plan. Members of the care team should engage patients in their fall prevention plan to increase their knowledge, skill, and confidence.