The Use of Assistive Technology to Reduce Harm from Falls - A Quality Improvement Project for Patients Admitted After a Fall

Introduction

Assistive technology (AT) may reduce the consequences of falls by enabling earlier access to assistance. Our initial service evaluation identified inconsistent assessment and documentation of AT needs in older adults admitted following a fall. This project evaluated the impact of a departmental educational intervention on assessment, documentation and onwards AT referral.

Method

Recommendations from Cycle 1 informed educational interventions comprising governance presentations and departmental teaching sessions. A retrospective case note audit was undertaken as part of a closed-loop quality improvement project. Consecutive patients admitted following a fall between 1 January and 31 March 2026 were reviewed. Data were collected on AT assessment, documentation and provision.

Results

A total of 30 patients were included (mean age 88.4 years; 60% female; median Clinical Frailty Score 6). Thirteen patients (43%) had existing AT before admission, although only 5 (38%) used it during their fall. Of 29 patients eligible for therapy assessment, 28 (97%) were reviewed by physiotherapy and 21 (72%) by occupational therapy. Documentation of AT increased from 22% to 50% in physiotherapy assessments and from 32% to 62% in occupational therapy assessments. Four patients received new AT referrals before discharge. Patients using AT spent less time on the floor than those without using AT (5.9 vs 8.5 hours), although this was an exploratory finding. One patient declined an impact alarm because of cost, highlighting affordability as a potential barrier to uptake.

Conclusion

Following the educational intervention, multidisciplinary assessment and documentation of AT improved, although new referrals remained limited. Patients using AT spent less time on the floor following a fall, while many patients with existing devices were not using them at the time of their fall. Future quality improvement should focus on improving appropriate referral, uptake and effective use of AT and evaluating its impact on patient outcomes.