[AVBC 2025] Stop the Drop! An Emergency Department Initiative to Reduce Falls
6 November 2025
Project Categories
Care Process & Redesign
Platform
Appropriate & Value-based Care Conference
Cluster
National Healthcare Group
The aim of the 'Stop the Drop!' initiative is to reduce and sustain the reduction of fall rates amongst ED patients. The initiative was successful in reducing falls and resource use in the ED.
Year Submitted: 2025
Published Date: 06 November 2025
Tags: Care Process ＆ Redesign, Quality Improvement, Workflow Redesign, Value Based Care, Safe Care, Risk Management
About this Content
Aims
The aim of the 'Stop the Drop!' initiative is to reduce and sustain the reduction of fall rates amongst ED patients.
Background
Tan Tock Seng Hospital sees 360 patients daily, 43% aged over 65. Patient falls are a major safety concern due to their association with higher morbidity and mortality. Causes include acute illness, intoxication, substance abuse, overcrowding, and long distances to toilets.
Methods
Fall incidents were reported via the hospitals incident reporting system. Between March 2022 and November 2023, the multidisciplinary falls team reviewed reports and mapped the patient journey. They used quality tools such as root cause analysis, cause-and-effect diagrams, brainstorming, and PDSA cycles to design and test interventions.
Results
Fall rates dropped from 7.8 to 3.5 per 10,000 ED attendances, with falls-related admissions, x-rays, and CT/MRI scans decreasing by 63%, 43%, and 56% respectively. A higher proportion of falls now involve intoxication or psychiatric patients.
Conclusion
The initiative was successful in reducing falls and resource use in the ED.
Lessons Learnt
The initiative reduced falls and resource use, but sustaining gains will require targeting high-risk groups, adapting to staffing/environmental challenges, and strengthening patient-family engagement.
Keywords
Falls Prevention, PDSA
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Medical, Nursing |
Applicable Specialty or Discipline | Emergency Medicine |
Project Lead(s) | Chiu Li Qi |
Project Member(s) | Qiu Hong |
Connect with this contributor!
Chiu Li Qi - li.qi.chiu@nhghealth.com.sg