Comments on: The unintended consequences of preventing patient falls http://www.kevinmd.com/blog/2009/07/the-unintended-consequences-of-preventing-patient-falls.html Wed, 15 Feb 2012 00:27:00 +0000 hourly 1 By: Lorindahttp://www.kevinmd.com/blog/2009/07/the-unintended-consequences-of-preventing-patient-falls.html#comment-109375 Lorinda Thu, 13 Aug 2009 23:28:34 +0000 http://www.kevinmd.com/blog/?p=39217#comment-109375 I saw some of the unintended consequences of this policy when my father was hospitalized recently. They either tied him down or had a 'don't get out of bed' nazi with him at all times. They would let him leave without being able to walk, but pt was only able to visit him once in 10 days so that he <I>could</I> walk. As a result he was damn near unable to make it up the 2 steps into the house when he got home. I realize that none of this is the hospital's fault, but really, fall at the hospital horrible, fall at home, at least it's not the hospital's fault. The consequences to patients on this one will only magnify over time. I saw some of the unintended consequences of this policy when my father was hospitalized recently. They either tied him down or had a ‘don’t get out of bed’ nazi with him at all times. They would let him leave without being able to walk, but pt was only able to visit him once in 10 days so that he could walk. As a result he was damn near unable to make it up the 2 steps into the house when he got home. I realize that none of this is the hospital’s fault, but really, fall at the hospital horrible, fall at home, at least it’s not the hospital’s fault. The consequences to patients on this one will only magnify over time.

]]> By: Matt MDhttp://www.kevinmd.com/blog/2009/07/the-unintended-consequences-of-preventing-patient-falls.html#comment-108399 Matt MD Thu, 23 Jul 2009 17:36:02 +0000 http://www.kevinmd.com/blog/?p=39217#comment-108399 Kevin - This issue hits a nerve. I can't tell you the countless hours of manpower and resources that our little rural access hospital is spending on this. The piles of paperwork are ridiculous. Our nurses are too busy learning what constitutes fall risk and how to avoid unintended "restraint" that they don't have time to review (or even learn in the first place) basic life saving skills as such as those taught in PALS and ACLS. When did we step away from patient care and become a business of paper? Kevin –
This issue hits a nerve. I can’t tell you the countless hours of manpower and resources that our little rural access hospital is spending on this. The piles of paperwork are ridiculous. Our nurses are too busy learning what constitutes fall risk and how to avoid unintended “restraint” that they don’t have time to review (or even learn in the first place) basic life saving skills as such as those taught in PALS and ACLS. When did we step away from patient care and become a business of paper?

]]> By: RehabRNhttp://www.kevinmd.com/blog/2009/07/the-unintended-consequences-of-preventing-patient-falls.html#comment-108328 RehabRN Wed, 22 Jul 2009 14:29:58 +0000 http://www.kevinmd.com/blog/?p=39217#comment-108328 Kevin:How timely...I was just talking about this issue with my old boss.They don't count patient stupidity (or carelessness) either when they lump all falls together, even when the patient is AOx3 and readily admits, "I just did it myself and never asked for help." Kevin:

How timely…I was just talking about this issue with my old boss.

They don’t count patient stupidity (or carelessness) either when they lump all falls together, even when the patient is AOx3 and readily admits, “I just did it myself and never asked for help.”

]]> By: Christinehttp://www.kevinmd.com/blog/2009/07/the-unintended-consequences-of-preventing-patient-falls.html#comment-108318 Christine Wed, 22 Jul 2009 04:55:57 +0000 http://www.kevinmd.com/blog/?p=39217#comment-108318 I like when we routinely get yelled at for having the highest rate of blood stream infections. The BMTU? Shocker. I like when we routinely get yelled at for having the highest rate of blood stream infections. The BMTU? Shocker.

]]> By: Donhttp://www.kevinmd.com/blog/2009/07/the-unintended-consequences-of-preventing-patient-falls.html#comment-108317 Don Wed, 22 Jul 2009 04:28:07 +0000 http://www.kevinmd.com/blog/?p=39217#comment-108317 Has anyone thought about just focusing on what is best for the health of the patients, rather than just chasing the money around like a Basset Hound? It always bothers me when I see "hospitals will do x instead" in order to ensure they are not penalized, even if it harms the patient just as much as "y" did. How about just doing what's right for the patient? If a hospital's response is to put a patient in physical restraints that are unwarranted, then that hospital is being greedy, unethical and very non-patient-focused. Maybe someday, hospital administrators will just choose to do the right things for the right reasons. It does not appear that today is that day.And, Kevin, rather than just outright condemning the idea of penalizing hospitals for something, like falls, that should not happen, it would be nice if you would offer an alternative rather than just advocating for the status quo. The status quo hasn't and doesn't work. That is why cutting-edge thinkers are pushing for change. Has anyone thought about just focusing on what is best for the health of the patients, rather than just chasing the money around like a Basset Hound? It always bothers me when I see “hospitals will do x instead” in order to ensure they are not penalized, even if it harms the patient just as much as “y” did. How about just doing what’s right for the patient? If a hospital’s response is to put a patient in physical restraints that are unwarranted, then that hospital is being greedy, unethical and very non-patient-focused. Maybe someday, hospital administrators will just choose to do the right things for the right reasons. It does not appear that today is that day.

And, Kevin, rather than just outright condemning the idea of penalizing hospitals for something, like falls, that should not happen, it would be nice if you would offer an alternative rather than just advocating for the status quo. The status quo hasn’t and doesn’t work. That is why cutting-edge thinkers are pushing for change.

]]> By: HospiceDochttp://www.kevinmd.com/blog/2009/07/the-unintended-consequences-of-preventing-patient-falls.html#comment-108306 HospiceDoc Tue, 21 Jul 2009 23:31:54 +0000 http://www.kevinmd.com/blog/?p=39217#comment-108306 SarahW, A patient shouldn't be able to sue for the bed rails being left down, we are required by law to leave them down now because putting them up is a form of "restraint" and therefore illegal. Damned if you do, damned if you don't. SarahW, A patient shouldn’t be able to sue for the bed rails being left down, we are required by law to leave them down now because putting them up is a form of “restraint” and therefore illegal. Damned if you do, damned if you don’t.

]]> By: jengahttp://www.kevinmd.com/blog/2009/07/the-unintended-consequences-of-preventing-patient-falls.html#comment-108278 jenga Tue, 21 Jul 2009 16:45:34 +0000 http://www.kevinmd.com/blog/?p=39217#comment-108278 The biggest one I see being a problem is catheter related infections. Why put a foley in anymore, if that goes down. People are going to have to like lying in their own piss. The biggest one I see being a problem is catheter related infections. Why put a foley in anymore, if that goes down. People are going to have to like lying in their own piss.

]]> By: Erikahttp://www.kevinmd.com/blog/2009/07/the-unintended-consequences-of-preventing-patient-falls.html#comment-108276 Erika Tue, 21 Jul 2009 16:10:57 +0000 http://www.kevinmd.com/blog/?p=39217#comment-108276 This reminds me (in a round-about way) of a tweet I saw recently from Houston's Memorial Hermann Hospital (@houstonhospital) telling people to "Avoid this unsafe equipment at the playground: animal swings, trampolines, monkey bars, swinging ropes, exercise rings and trapeze bars." Sure, but then wonder why kids are more & more inactive, and why they seem to find the playground boring... http://twitter.com/houstonhospital/status/2407006217 This reminds me (in a round-about way) of a tweet I saw recently from Houston’s Memorial Hermann Hospital (@houstonhospital) telling people to “Avoid this unsafe equipment at the playground: animal swings, trampolines, monkey bars, swinging ropes, exercise rings and trapeze bars.” Sure, but then wonder why kids are more & more inactive, and why they seem to find the playground boring…
http://twitter.com/houstonhospital/status/2407006217

]]> By: SarahWhttp://www.kevinmd.com/blog/2009/07/the-unintended-consequences-of-preventing-patient-falls.html#comment-108275 SarahW Tue, 21 Jul 2009 16:09:02 +0000 http://www.kevinmd.com/blog/?p=39217#comment-108275 How about patients sue when they aren't cared for properly, and are dropped after mishandling, or left with bed rails down while they are at high risk of being unable to stop a fall?That seems incentive enough, the threat of financial loss for negligence, to adopt safe practices.Shocking solution, this "individual circumstance" evaluation. How about patients sue when they aren’t cared for properly, and are dropped after mishandling, or left with bed rails down while they are at high risk of being unable to stop a fall?

That seems incentive enough, the threat of financial loss for negligence, to adopt safe practices.

Shocking solution, this “individual circumstance” evaluation.

]]> By: David Harlowhttp://www.kevinmd.com/blog/2009/07/the-unintended-consequences-of-preventing-patient-falls.html#comment-108273 David Harlow Tue, 21 Jul 2009 16:06:36 +0000 http://www.kevinmd.com/blog/?p=39217#comment-108273 It's the law of unintended consequences: push in on the balloon here, it bulges out there. The focus on never events not only has this result, but the Medicare rule as currently structured saves only $21 million/year (CMS's own figures; see http://bit.ly/z8JFO) which is bupkes (a technical term).This is one of the many reasons that patches to the FFS system won't work well, and that a move to a global payment system will work better. It’s the law of unintended consequences: push in on the balloon here, it bulges out there. The focus on never events not only has this result, but the Medicare rule as currently structured saves only $21 million/year (CMS’s own figures; see http://bit.ly/z8JFO) which is bupkes (a technical term).

This is one of the many reasons that patches to the FFS system won’t work well, and that a move to a global payment system will work better.

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