Hospital falls: turn individual assessment into a practical prevention plan

Risk differs between patients

Illness, medicines, unfamiliar surroundings and changing mobility can make hospital activities harder than at home. AHRQ Fall TIPS links assessment to a personalized plan and consistent implementation, involving patients and families. ^[1] A generic warning sign cannot explain all the assistance an individual needs.

Do not confuse a score with prediction

NICE NG249, published in 2025 and replacing CG161, advises against using falls risk prediction tools to predict who will fall and recommends comprehensive assessment. Its population is adults aged 65 and over, and people aged 50–64 with risk factors; it is not guidance for every age group. ^[2]

An ICORP implementation proposal

Agree an assessment approach suited to the service, then turn identified needs into a plain-language plan: when assistance is needed, whom to call and where recommended equipment is available. Invite the patient to explain the plan and practical barriers. Revisit it when the condition or treatment changes.

Check whether help is available

Suggested monitoring asks whether patients and carers understand the plan and whether the agreed assistance is delivered. Review falls and near misses for recurring factors using consistent definitions. These are local improvement proposals, not accreditation targets or a claim that patients with low scores are safe from falling.