In the inpatient behavioral health setting falls are the most frequently reported incident with fall rates ranging from 4.1 to 25 per thousand patient days, rates almost twice that of the acute care setting (non-behavioral health). Several researchers have identified fall risk factors unique to behavioral health inpatients; however, to date no standardized fall-injury risk assessment model has been reported for use in this setting. Identification of the most predictive risk model will facilitate automated risk assessment, targeted safety measure use and comprehensive documentation. Integration of standardized risk assessment into the clinical information system for use at the point of care can provide a method to reduce practice variation and can facilitate reuse of data at the individual and administrative level. Evidence supporting the use of informatics applications to promote patient safety and to promote standardization of patient care is increasing and warrants investigation related to nursing sensitive quality indicators. The purpose of this research is to develop and validate a fall and injury risk assessment model, to identify appropriate safety measures to support clinical decision making and documentation, and to develop and test a computer-based prototype for use by individuals caring for patients in the behavioral health setting. There are three specific aims for this research: 1) To develop and validate a fall and injury risk assessment model for use in the inpatient behavioral health setting; 2) To identify safety measures for fall and injury prevention for use in the inpatient behavioral health setting; and 3) To develop and test a prototype of an automated fall and injury risk assessment model with targeted safety measures for hospitalized behavioral health patients. ? During the two year research study period we plan to perform the following procedures: 1) Fall-injury risk model identification via a retrospective case-control study; 2) Validation of the risk model on a second group of patients over a 9 month period; 3) Focus groups and literature review to identify fall and injury prevention safety measures for the behavior health setting; and 4) Computer-based prototype development and testing. This research will produce a fall and injury risk assessment model, a list of evidence-based safety measures that can be targeted to risk factors and a computer-based prototype for risk assessment and safety measure documentation. The study will be carried out in a healthcare system network with five sites and sixteen behavioral health units in urban and community settings. This research has the potential to improve the quality of care and safety for patients at risk for falling in the behavioral health setting. Falls are the most frequently reported incident in inpatient behavioral health units, with rates almost twice that of general hospital units. Fall-related injuries can lead to serious health problems including fractures and sometimes even death, therefore fall prevention is an important public health goal. To date, no standardized fall-injury risk assessment model has been developed for use with behavioral health patients; therefore the purpose of this research is to develop a fall and injury risk assessment model and to build a computerized prototype to help clinicians select appropriate safety measures to prevent falls and injuries. ? ? ?
