Anyone working in healthcare knows that patient falls are a serious safety concern. Several studies in Canada have shown that patients who fall while in hospital experience functional decline, decreased mobility and premature admission to residential care homes. Consequently, the costs incurred by our healthcare system are significant.

Until recently, few Canadian studies have looked at the correlation between degree of harm for injuries associated with falls and the patient’s length of stay in hospital. But work by a team at Vancouver General Hospital (VGH) recently published in the Journal of Evaluation in Clinical Practice suggests that patients who experience a fall while in-hospital have a longer length of stay, regardless of degree of harm.

In this innovative study, researchers looked at 1,307 patients who had at least one fall between November 1, 2009 and August 31, 2011 at VGH, a 728-bed acute care teaching hospital. Data for the study came from two web-based reporting systems: The BC Patient Safety & Learning System (BC PSLS), the provincial incident reporting tool used at VGH and across BC’s healthcare facilities, and the Discharge Abstract Database (DAD), a tool used across the Canadian healthcare system to track discharge, demographic and clinical patient information.

Patients who experienced a fall during their stay – with injury or without – stayed an average of 11.5 days longer than patients who did not fall. Patients who did not fall were 2.4 times more likely to be discharged earlier.

“Those of us in falls prevention are always looking for ways to evaluate what we’re doing so we can improve,” says Tanya Dunne, Regional Lead for the Fall and Injury Prevention Program at Vancouver Coastal Health, and lead researcher for this study. “That was the impetus to this research – to determine how long our patients were in hospital after experiencing a fall and what impact that had on our system and resources.”

In-hospital fall prevention protocols are known to improve patient outcomes, and the results of this research certainly validate the need for having these practices in place. But, more importantly, this research gives care providers more knowledge about the impact of in-hospital falls, with or without harm, which may ultimately lead to improvements in quality of care and patient safety in BC healthcare facilities. “What’s so interesting about this study is that 95% of the patients we studied had minor or no harm from the fall, yet there was a significant increase in the length of stay in hospital.”

This research was a partnership between Tanya J. Dunne, Regional Lead for the Fall and Injury Prevention Program at Vancouver Coastal Health, Dr. Isabelle Gaboury, with the Department of Family Medicine at the University of Sherbrooke and Maureen Ashe, investigator with the Centre for Hip Health and Mobility and Associate Professor with the Department of Family Practice at the University of British Columbia. To learn more, please contact Tanya Dunne at

Article reference: Dunne, T. J., Gaboury, I. and Ashe, M. C. (2014), Falls in hospital increase length of stay regardless of degree of harm. Journal of Evaluation in Clinical Practice, 20: 396–400. doi: 10.1111/jep.12144

Additional resource:

Preventing Falls: From Evidence to Improvement in Canadian Health Care

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