Using a Co-Designed Implementation Enhancement Plan to Increase the Adoption of a Digital Fall Prevention Platform: A Non-Randomized Pre-Post Interventional Study

Abstract

Background: Falls are a major cause of hospital acquired complications and inpatient harm. Interventions to prevent falls exist, but it is unclear which are most effective and what implementation strategies best support their use. This study sought to ascertain the impact of a co-designed implementation enhancement plan on the adoption and effect of a digital fall prevention platform in a new hospital.

Methods: A non-randomized pre-post interventional study using multi-methods. A bespoke survey as well as descriptive and inferential statistical analysis of hospital administrative data and were used to identify the impact on: (1) adoption of the system and (2) the rate of falls.

Results: The co-design implementation enhancement plan successfully improved the adoption of some key platform functions, most importantly, a 39% increase (p = 0.04) in setting a patient as having a high risk of falling on the staff station console. There were also improvements in staff response times, satisfaction and perceptions of the fall prevention platform. A risk reduction in falls per 1000 bed days was observed among cognitively intact patients post implementation enhancement plan, however, this difference was not statistically significant (OR = 0.97 95% CI [0.78,1.22] p = 0.77).

Conclusion: The co-designed implementation enhancement plan improved uptake of the platform and is likely to be effective for other similar interventions. The platform shows the potential to reduce falls among cognitively intact patients, but longer periods of observation and a larger sample are needed to confirm the effect. Aside from falls, a reduction in nurse response time is likely to improve patient care and experience.

Keywords: co-design; health information technology; implementation science; nursing.