Achieving a high quality, fully-integrated falls service in Sheffield: a clinical microsystems nurse-led redesign

Yorkshire & HumberInjuries and Accidents
Start Date: 1 Jan 2013


Falls pose a local and national challenge to the ageing population who have an increasingly high expectation of active living. People aged 65 and older are at most risk of falling, with a third of people older than 65 years and half of people older than 80 years falling at least once per year (NICE 2013).

The human cost of falling is significant in that falls cause distress, pain, injury, loss of confidence and loss of independence to the individual. Experiencing a fall impacts upon a person’s quality of life as well as affecting relatives and carers (NICE 2013).

The reasons why people fall are complex and influenced by contributing factors such as physical illness, cognitive impairment, side effects of medication, problems with balance and mobility, and increasing age. A change in environment, for example admission to hospital, significantly increases the risk of falling in older people, especially when compounded by problems of poor sight or poor memory. Hospital patients have a greater risk of falling than people in the community and falls in hospital are the most common patient safety incident reported in UK hospital trusts


Aims of the project

1. Empower nurses and other staff to lead, integrate and transform a citywide falls service drawing upon the clinical microsystems quality improvement methodology.

2. Develop an integrated hospital and community service designed by staff and patients to optimise patient-centred evidence-based care in falls prevention and management.

3. Build capacity among nurses and other healthcare professionals to sustain continuous quality improvement.

4. Evaluate the initiative in order to capture learning.

5. Ascertain the economic benefits of the new service.

Prof Kate Gerrish