IVEA Mobility Blog

Joint Commission Finds Falls a Stubborn Problem – But Are Hospitals Doing All They Can to Solve It?

March 31, 2017

IVEA with patientIn the Joint Commission’s recent ranking of the 10 Most Common Sentinel Events of 2016, patient falls came in third. The Commission reviewed 824 events, and 92 of them were falls. Only “unintended retention of a foreign body” (120) and “wrong patient, wrong site, wrong procedure” (104) ranked higher.

The commission’s 2015 review of sentinel events documented 95 falls and more than 930 events were reviewed that year. That would suggest that fall rates are rising, even at a time when safe patient handling is a prime focus and staff is swimming in fall-risk assessment tools, committees, communication protocols, care plans and environmental improvements.

There’s good reason for the concentration of effort around this issue. According to the Agency for Healthcare Research and Quality, between 700,000 and 1 million patients fall in the hospital each year. Approximately 30 percent of falls result in injury and 4 to 6 percent are serious, including subdural hematomas, excessive bleeding and even death.

The average cost of a patient fall is $14,000.[1] And costs can go much higher when you factor in increased length of stay and loss of CMS reimbursement dollars.

And patients aren’t the only ones at risk. Caregivers struggling to manage sicker and larger patients with fewer staff are getting hurt more often. More than 35,000 nurses are injured each year.[2] Debilitating staff injuries can end careers, and workers comp and replacement costs combined can top six figures per case.

So what’s not working? With so much incentive to reduce falls, why are they still the third most prevalent sentinel event? One simple reason is that falls occur for multiple reasons – physical, psychological and environmental – so it’s impossible to eliminate them entirely. But another factor – one that perhaps doesn’t receive the attention it deserves – is that caregivers often mobilize patients using equipment designed more than a century ago.

The IV pole became a hospital-room mainstay at a time when patients rarely ambulated. Today, patients are often urged to get out of bed mere hours after major surgery. And what are many caregivers using to get their patients up and moving? IV poles.

It’s understandable. Until recently there hasn’t been a better option. But now there is. The IVEA holds all of the patient’s equipment bedside and provides stable, ergonomic support for ambulation. As one PT in a Cincinnati put it: “The IVEA means that I can do what it typically takes two or three people to do, and that frees up time to focus on more difficult patients.”

Hospitals serious about reducing falls are looking at comprehensive approaches that consider all aspects of risk. The IVEA is an important piece of the puzzle that shouldn’t be overlooked. For more information and a free product demonstration, please call (970) 472-5323 or email info@iveamobility.com.


[1] The Joint Commission, “Sentinal Event,” Issue 55, (Sept. 28, 2015)

[2] Bureau of Labor Statistics 

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