Choosing Wisely: De-implementing Fall Prevention Alarms in Hospitals
De-Implementing Fall Prevention Alarms in Hospitals
2 other identifiers
interventional
300
1 country
24
Brief Summary
This is a Hybrid II de-implementation study to reduce use of fall prevention alarms in hospitals. The intervention consists of tailored, site-specific approaches for three core implementation strategies: education, audit/feedback and opinion leaders. Hospital units will be randomized to low-intensity or high-intensity coaching for the implementation of the tailored strategies.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Oct 2023
Typical duration for not_applicable
24 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
September 18, 2023
CompletedStudy Start
First participant enrolled
October 1, 2023
CompletedFirst Posted
Study publicly available on registry
October 18, 2023
CompletedPrimary Completion
Last participant's last visit for primary outcome
February 2, 2026
CompletedStudy Completion
Last participant's last visit for all outcomes
August 31, 2026
ExpectedJuly 16, 2025
July 1, 2025
2.3 years
September 18, 2023
July 14, 2025
Conditions
Outcome Measures
Primary Outcomes (2)
Fall Prevention Alarm Prevalence survey
Number of Patients in a study unit with fall prevention alarm activated divided by the number of patients evaluated. This is assessed monthly and is expressed as the proportion of patients assessed with fall prevention alarm activated. This is not a time to event outcome. This measure will be recorded monthly for 30 months during both baseline and intervention periods.
monthly for 30 months
Patient Falls
Patients on participating units are monitored for falls beginning the date/time they are admitted to the date/time they are discharged from the study unit. Falls are determined using National Database of Nursing Quality Indicators (NDNQI) protocols. Patients may contribute one or more falls during their stay. This is expressed as the Number of Patients who fell/1000 bed days of care. This measure will be recorded monthly for 30 months during both baseline and intervention periods.
monthly for 30 months
Study Arms (2)
High Intensity Coaching
ACTIVE COMPARATORIn Quarter 1, high intensity initiation coaching will consist of a four-hour orientation session that will include: * comprehensive information on behavior and organizational change theory, * suggested approaches, and * in-depth training on behavioral and organization-focused change techniques to stimulate implementation efforts. Commencing in Quarter 2, high intensity sustainability coaching will consist of: * weekly virtual follow up sessions for the first month, followed by private monthly coaching follow up sessions via a virtual format. * Access to additional monthly web-based, synchronous "office hours" for group discussion on progress and customized troubleshooting to assist in navigating barriers. * Sites will also have access to "on call" assistance with coaches to assist with navigating challenges in real time.
Low Intensity Coaching
SHAM COMPARATORIn Quarter 1, low intensity initiation coaching will be conducted. It will consist of: * initial two-hour orientation session with introductory content on behavior change and organizational change theory and techniques, * an overview of implementation phases, and * selection of tailored de-implementation strategies for that site based on readiness for change, focus group data and local resources. Implementation coaches will provide the Fuld Toolkit for the site with suggestions for assigning strategies, local leaders, and development of timelines for de-implementation. Coaches will instruct site Team Leaders to establish the primary mechanism for sharing baseline and trended data in real time.
Interventions
External coaching is a commonly used strategy to change practice, especially for multi-site collaboratives where implementation requires customization to the site. Coaches serve as skill builders who train organizational personnel in quality improvement processes and develop proficiency in the targeted practice area (i.e., fall prevention).
External coaching is a commonly used strategy to change practice, especially for multi-site collaboratives where implementation requires customization to the site. Coaches serve as skill builders who train organizational personnel in quality improvement processes and develop proficiency in the targeted practice area (i.e., fall prevention).
Eligibility Criteria
You may qualify if:
- Stakeholders in fall prevention at up to 30 participating NDNQI hospitals
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- University of Floridalead
- National Institute on Aging (NIA)collaborator
Study Sites (24)
PIH Health Downey Hospital
Downey, California, 90241, United States
El Camino Health - Los Gatos
Mountain View, California, 94040, United States
University of California Davis Medical Center
Sacramento, California, 95817, United States
Lakeland Regional Medical Center
Lakeland, Florida, 33809, United States
OSF Saint Anthony's Health Center
Alton, Illinois, 62002, United States
Central DuPage Hospital
Winfield, Illinois, 60190, United States
Hendricks Regional Health
Danville, Indiana, 46122, United States
IU Health North Hospital
Indianapolis, Indiana, 46256, United States
UMass Memorial Health Harrington
Southbridge, Massachusetts, 01550, United States
Henry Ford Hospital West Bloomfield
West Bloomfield, Michigan, 48322, United States
Lahey Hospital & Medical Center
Derry, New Hampshire, 03038, United States
Hunterdon Medical Center
Flemington, New Jersey, 08822, United States
Raritan Bay Medical Center
New Brunswick, New Jersey, 08861, United States
Greenwich Hospital
River Vale, New Jersey, 07675, United States
St Peter's Health Samaritan Hospital
Albany, New York, 12208, United States
Grant Medical Center
Columbus, Ohio, 43215, United States
Barberton Hospital
Uniontown, Ohio, 44685, United States
Kaiser Westside Medical Center
Hillsboro, Oregon, 97124, United States
Kaiser Permanente - Sunnyside Medical Center
Woodburn, Oregon, 97071, United States
Christiana Care
West Chester, Pennsylvania, 19382, United States
Kent Hospital
Warwick, Rhode Island, 02886, United States
Prisma Health
Irmo, South Carolina, 29063, United States
St. David's Medical Center
Austin, Texas, 78703, United States
Covenant Medical Center
Lubbock, Texas, 79410, United States
Related Publications (1)
Turner K, McNett M, Potter C, Cramer E, Al Taweel M, Shorr RI, Mion LC. Alarm with care-a de-implementation strategy to reduce fall prevention alarm use in US hospitals: a study protocol for a hybrid 2 effectiveness-implementation trial. Implement Sci. 2023 Dec 5;18(1):70. doi: 10.1186/s13012-023-01325-9.
PMID: 38053114DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Ronald I Shorr, MD
University of Florida
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
September 18, 2023
First Posted
October 18, 2023
Study Start
October 1, 2023
Primary Completion
February 2, 2026
Study Completion (Estimated)
August 31, 2026
Last Updated
July 16, 2025
Record last verified: 2025-07
Data Sharing
- IPD Sharing
- Will not share