title: Is there a link between the hospital-acquired injurious fall rates in US acute care hospitals and these institutions' implementation levels of computerized systems?
abstract: Medicare no longer reimburses acute care hospitals for the costs of additional care required due to hospital-acquired injuries. Consequently, this study explored the effective computerized systems to inform practice for better interventions to reduce fall risk. It provided a correlation between type of computerized system and hospital-acquired injurious fall rates at acute care hospitals in California, Florida, and New York. It used multiple publicly available data sets, with the hospital as the unit of analysis. Descriptive and Pearson correlation analyses were used. The analysis included 462 hospitals. Significant correlations could be categorized into two groups: (1) meaningful computerized systems that were associated with lower injurious fall rates: the decision support systems for drug allergy alerts, drug-drug interaction alerts, and drug-laboratory interaction alerts; and (2) computerized systems that were associated with higher injurious fall rates: the decision support system for drug-drug interaction alerts and the computerized provider order entry system for radiology tests. Future research may include additional states, multiple years of data, and patient-level data to validate this study's findings. This effort may further inform policy makers and the public about effective clinical computerized systems provided to clinicians to improve their practice decisions and care outcomes.
authors.affiliation: Department of Nursing, School of Health Professions and Studies, University of Michigan-Flint, USA. tzenghm@gmail.com
authors.forename: Huey-Ming
authors.initials: HM
authors.lastname: Tzeng
authors.forename: Hsou Mei
authors.initials: HM
authors.lastname: Hu
authors.forename: Chang-Yi
authors.initials: CY
authors.lastname: Yin
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D002140:California; D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D005431:Florida; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D050316:Medical Order Entry Systems / Q000458:organization & administration*; D009518:New York; D019984:Quality Indicators, Health Care; D012308:Risk Management