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Evaluating the use of multiteam systems to manage the complexity of inpatient falls in rural hospitals

Objective: To evaluate the implementation and outcomes of evidencebased fallriskreduction processes when those processes are implemented using a multiteam system (MTS) structure.

Data Sources/Study Setting: Fallriskreduction process and outcome measures from 16 small rural hospitals participating in a research demonstration and dissemination study from August 2012 to July 2014. Previously, these hospitals lacked a fallevent reporting system to drive improvement.

Study Design: A onegroup pretestposttest embedded in a participatory research framework. We required hospitals to implement MTSs, which we supported by conducting education, developing an online toolkit, and establishing a fallevent reporting system.

Data Collection: Hospitals used gap analyses to assess the presence of fallriskreduction processes at study beginning and their frequency and effectiveness at study end; they reported fallevent data throughout the study.

Principal Findings: The extent to which hospitals implemented 21 processes to coordinate the fallriskreduction program and trained staff specifically about the program predicted unassisted and injurious fall rates during the endofstudy period (January 2014July 2014). Bedside fallriskreduction processes were not significant predictors of these outcomes.

Conclusions: Multiteam systems that effectively coordinate fallriskreduction processes may improve the capacity of hospitals to manage the complex patient, environmental, and system factors that result in falls.

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