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The SCOPE of hospital falls: a systematic mixed studies review

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journal contribution
posted on 27.05.2016 by Ellen Taylor, Sue Hignett
Purpose: This systematic mixed studies review (MSR) on hospital falls is aimed to facilitate proactive decision-making for patient safety during the healthcare facility design. Background: Falls were identified by the Centers for Medicare & Medicaid Services (CMS) as a non-reimbursed hospital acquired condition (HAC) due to volume and cost, and additional financial penalties were introduced with the 2014 US hospital acquired condition (HAC) reduction program. In 2015, a Joint Commission alert identified patient falls as one of the top reported sentinel events, and the Occupational Safety and Health Administration (OSHA) added slips, trips, and falls as a focus for investigators' healthcare inspections. Variations in fall rates at both the hospital and the unit level is indicative of an ongoing challenge. The built environment can act as a barrier or enhancement to achieving the desired results in safety complexity that includes the organization, people and environment (SCOPE). Methods: The systematic literature review used MeSH terms and key word alternates for hospital falls with searches in MEDLINE, Web of Science, and CINAHL. The search was limited to English-language papers. Results: Following full text review, 27 papers were included and critically appraised using a dual method mixed methods critical appraisal tool. Themes were coded by broad categories of factors for organization (policy/operations), people (caregivers/staff, patients); and the environment (healthcare facility design). Subcategories were developed to define the physical environment and consider the potential interventions in the context of relative stability. Conclusions: Conditions of hospital falls were identified and evaluated through the literature review. A theoretical model was developed to propose a human factors framework, while considering the permanence of solutions.



  • Design

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Health Environments Research & Design Journal






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TAYLOR, E. and HIGNETT, S., 2016. The SCOPE of hospital falls: a systematic mixed studies review. Health Environments Research and Design Journal, DOI: 10.1177/1937586716645918.


SAGE (© the authors)


AM (Accepted Manuscript)

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This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

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