They’re called sentinel events by the Joint Commission, the independent organization that accredits U.S. hospitals.
That’s a euphemism for incidents in institutions that cause “death, permanent harm or severe temporary harm.”
Falls are the No. 1 voluntarily reported sentinel events occurring each year in hospitals. They made up half the number of serious patient harms recorded by the commission, which expressed concern in 2023 about their still-increasing numbers and blamed the coronavirus pandemic for worsening efforts to improve patient safety, especially with falls.
Doctors, nurses, and others who work in hospitals have campaigned for a while now to decrease this preventable harm for the vulnerable in their care. As the commission noted in a longstanding alert to its member institutions:
“Elderly and frail patients with fall risk factors are not the only ones who are vulnerable to falling in health care facilities. Any patient of any age or physical ability can be at risk for a fall due to physiological changes due to a medical condition, medications, surgery, procedures, or diagnostic testing that can leave them weakened or confused…
“Every year in the United States, hundreds of thousands of patients fall in hospitals, with 30%-50% resulting in injury. Injured patients require additional treatment and sometimes prolonged hospital stays. In one study, a fall with injury added 6.3 days to the hospital stay. The average cost for a fall with injury is about $14,000 …”
Nursing homes, skilled nursing facilities, and other care-giving centers share with hospitals the problem of patient falls — a problem afflicting 700,000 to 1 million of them annually, according to information from a federal quality and safety health care agency.
Experts know that the ailing, injured, and old take their spills while walking around facilities, getting out of bed, struggling with wheelchairs, or using the bathroom.
It’s understandable: Patients find themselves strapped into an array of electronic monitors and cords and intravenous lines while wearing unfamiliar garb and footwear.
In a perfect world, nurses or aides would be instantly assisting patients as they navigate their space while dealing with their own infirmities and the confusion of modern health care facilities. In reality, dazed patients try to get up alone and then tumble to the floor. They feel the discomfort and urgency of needing a bathroom and can’t wait after signaling for help.
They also may be trying to walk in a hall where liquids have spilled, or unforeseen obstacles (carts, floor coverings, other patients) may trip them up. The lighting may be dimmed (at night) or just poor.
To safeguard patients from falls, hospital staff have policies and procedures they’re supposed to comply with.
Clearly, more needs to be done. But there’s an increasingly common shift-and-shaft approach to dealing with institutional falls, particularly those in care facilities for the elderly. First responders are expressing increasing frustration and alarm that nursing homes, skilled nursing facilities, and assisted-living centers are calling 911 to get fire fighters and paramedics for “lift assists” — help in getting residents up after a fall.
Embarrassed residents and staffers say that facilities lack the equipment and muscle to assist seniors who have taken a fall. Aides worry about injuring their own backs. Facility owners and operators express concern about legal liabilities. Burdening first responders is becoming an unhappy and too-common practice, the Washington Post found, reporting this:
“Lift assists are now the seventh most common type of 911 call, with an average of 1,800 lift-assist calls every day nationwide, according to an analysis of the National Fire Incident Reporting System, which collects emergency calls from more than 23,000 fire departments. The data does not include calls to about 13,700 EMS agencies, although there is significant overlap in calls between the two databases.
“The calls come often from elderly people living both at home and at facilities. While both situations strain resources, fire officials said senior-care homes should be equipped to handle these calls.”
Some agencies have begun assessing fees for lift assists, a response that upsets the owners and operators of care facilities. They say that residents should get governmental help whether at home or in an institution because they and their loved ones fund fire and government paramedic services with taxes.
The friction is increasing between local governments and care facilities. Besides the fees, shouldn’t fire and government paramedic agencies be keeping track of excessive lift assist calls from certain spots, reporting them, in turn, to state and federal regulators overseeing such facilities?