Measuring falls events in acute hospitals-a comparison of three reporting methods to identify missing data in the hospital reporting system.
OBJECTIVE
To compare three different methods of falls reporting and examine the characteristics of the data missing from the hospital incident reporting system.


METHODS
Fourteen-month prospective observational study nested within a randomized controlled trial.


METHODS
Rehabilitation, stroke, medical, surgical, and orthopedic wards in Perth and Brisbane, Australia.


METHODS
Fallers (n=153) who were part of a larger trial (1,206 participants, mean age 75.1 + or - 11.0).


METHODS
Three falls events reporting measures: participants' self-report of fall events, fall events reported in participants' case notes, and falls events reported through the hospital reporting systems.


RESULTS
The three reporting systems identified 245 falls events in total. Participants' case notes captured 226 (92.2%) falls events, hospital incident reporting systems captured 185 (75.5%) falls events, and participant self-report captured 147 (60.2%) falls events. Falls events were significantly less likely to be recorded in hospital reporting systems when a participant sustained a subsequent fall, (P=.01) or when the fall occurred in the morning shift (P=.01) or afternoon shift (P=.01).


CONCLUSIONS
Falls data missing from hospital incident report systems are not missing completely at random and therefore will introduce bias in some analyses if the factor investigated is related to whether the data is missing. Multimodal approaches to collecting falls data are preferable to relying on a single source alone.
Hill
Anne-Marie
AM
School of Health Sciences, Physiotherapy, The University of Notre Dame Australia, PO Box 1225, Fremantle, WA 6959, Australia. ahill3@nd.edu.au
Hoffmann
Tammy
T
Hill
Keith
K
Oliver
David
D
Beer
Christopher
C
McPhail
Steven
S
Brauer
Sandra
S
Haines
Terry P
TP
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D005260:Female; D005568:Forms and Records Control; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008499:Medical Records; D010353:Patient Education as Topic; D011446:Prospective Studies; D015203:Reproducibility of Results; D012308:Risk Management / Q000379:methods*