Transformation Initiatives in Reducing Inpatient Falls and Skin Associated Injuries
Care Process & Redesign
National Healthcare Innovation and Productivity Medals
Agency for Integrated Care - Intermediate and Long Term Care
30 January 2026
To improve equipment standards and maintenance practice, and to implement a Falls Prevention and Skin Integrity Management. The interventions were successful in reducing falls and associated injuries, enhancing staff knowledge and skills, and promoting a.
Year Submitted: 2025
Published Date: 30 January 2026
Tags: Care Process ＆ Redesign, Quality Improvement, Workflow Redesign, Value Based Care, Safe Care
About this Content
Aims
To improve equipment standards and maintenance practice, and to implement a Falls Prevention and Skin Integrity Management Program for all Therapy staff.
Background
Falls among hospital inpatients are a common concern, with an average incidence of 0.7 per 1000 patient-days at Ang Mo Kio-Thye Hua Kwan Hospital. Injuries from falls can hinder recovery, increase healthcare costs, and extend hospital stays.
Methods
A thematic analysis of qualitative therapy-related Hospital Occurrence Reports (HORs) from 2021 and a convenience sampling staff survey were conducted to identify the main contributing factors for falls and skin-associated injuries.
Exploration and implementation of patient education, such as face-to-face talks and improved orientation guidelines, may be useful in addressing skin injuries.
Results
In 2023, there was a 26.7% reduction in total HOR incidences compared to 2021. Assisted and unassisted fall incidences fell by 20% and 80% respectively, and falls resulting in injuries reduced by 100%. However, skin injuries increased by 20% compared to 2021.
Conclusion
The interventions were successful in reducing falls and associated injuries, enhancing staff knowledge and skills, and promoting a positive learning environment. However, additional interventions may be needed to address skin injuries.
Lessons Learnt
Interventions did not yield positive effects on skin injuries, which increased by 20%. Factors such as comorbidities and cognitive changes in patients were identified as influencing skin integrity and injury occurrence.
Keywords
Falls Prevention, Skin Integrity, Therapy Services, Patient Safety
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | Agency for Integrated Care - Intermediate and Long Term Care |
Organization(s) Involved | Ang Mo Kio Thye Hua Kwan Hospital |
Platform(s) | National Healthcare Innovation and Productivity Medals |
Healthcare Professional Group(s) | Allied Health |
Applicable Specialty or Discipline | Allied Health, Occupational Therapy, Physiotherapy |
Project Lead(s) | Jasreel Si Yan Yu |
Project Member(s) | Gwee Yuan |
Connect with this contributor!
Jasreel Si Yan Yu - Jasreel_si@amkh.org.sg
Gwee Yuan - yuan_gwee@amkh.org.sg