Here’s why falls are a top cause of injury in Connecticut hospitals — and what’s being done about it

CT Insider – Monday, April 14, 2025
By Liese Klein

You’re a patient in a hospital, it’s late at night, and you really have to use the bathroom. There are no nurses or other medical staff in sight, so you ease yourself out of the bed and make your way across the room on your way to the toilet, only to slip and fall to the floor. Forget what brought you to the hospital in the first place ‒ that fall could seriously injure or even kill you.

When it comes to preventable “never events” in hospitals, patient falls that result in serious injury or death continue to dominate statistics, even as other incidents like retained objects and medication errors tend to dominate the headlines.

“We all recognize that at some point patients may fall in an institution,” said Caryl Ryan, vice president for quality and patient care services at UConn Health. “The goal is having zero falls with injury. That’s really what we want to see.”

Falls remain a top cause of injury in hospitals

Like other “never events,” serious falls continue to persist in hospitals and other health care settings despite ongoing safety efforts. An estimated 700,000 to 1 million hospitalized patients fall each year nationwide, according to the federal Agency for Healthcare Research and Quality, with one-third of those falls resulting in injury.

Serious injuries or deaths related to falls ranked second to pressure ulcers in the total number of serious adverse events in Connecticut hospitals and care sites from 2013 through 2023, according to a recent state report.

Despite ongoing safety campaigns, reports of serious falls in Connecticut health facilities rose over that period, from 90 in 2013 to 101 in 2023. By contrast, reports of pressure ulcers declined from a high of 277 in 2013 to 221 in 2023.

Never events in total in Connecticut health-care settings have gone up in the post-pandemic period.

The state’s Quality in Health Care Program presented its latest report on adverse events to the General Assembly in October 2024. Using the data in the report, staff from the DPH Facilities Licensing and Investigations section visits hospitals and other sites to “evaluate the event and work with the facility on prevention of future events,” a spokesperson said.

DPH staffers also meet regularly with hospitals and the Connecticut Hospital Association to discuss common incidents. “This exchange of information allows DPH to call hospital representatives’ attention to the more frequently occurring adverse events,” the spokesperson said.

In the most recent DPH report, “falls resulting in serious disability or death” was the second-most-common adverse-event category in 2023, making up 22% of reported incidents, while “retained foreign objects after surgery” dropped to the fourth most common, at 4% of incidents.

The toll from falls at hospitals is part of a growing problem as the population ages and people live longer with serious illnesses, experts say. Already the seventh-oldest state in the nation, Connecticut will see its population of 65-plus adults grow by 57 percent by 2040, according to a state report published last year.

The age-adjusted fall death rate for older adults nationwide jumped by 41% between 2012 and 2021, according to the Centers for Disease Control, from 55.3 per 100,000 in 2012 to 78.0 per 100,000 in 2021. Researchers attribute the increase in part to the fact that many seniors are living longer with serious medical conditions that can contribute to catastrophic falls.

According to state data, 411 older adults in Connecticut died from falls in all settings in 2023, and 36,534 were sent to the hospital for care.

One-third of Connecticut residents 65 and older fall each year, according to a 2019 report, with falls credited as the leading cause of injury-related death in the same age group.

The DPH and the Department of Aging and Disability Services publish a guide to fall-prevention efforts like chair yoga classes and balance screenings across the state as part of the Falls Free CT coalition. The CDC also recommends screening older adults for risk factors that can contribute to falls like weakness, poor balance and the use of medications that can impair movement.

Hospital safety efforts home in on human factor

The fact that falls and other health-care accidents persist amid advances in technology and safety practices highlight the fact that humans are prone to make mistakes, and humans still do much of the work in hospitals, experts say.

Modern efforts to reduce health-care “never events” launched after the 1999 release of an Institute of Medicine report called “To Err is Human,” which attributed nearly 98,000 hospital deaths a year to medical errors.

“The problem is not bad people in health care ‒ it is that good people are working in bad systems that need to be made safer,” the report’s summary reads.

In 2012, Connecticut was the first state in the nation to create a ‘high reliability” program to reduce “never events” in hospitals, seeking to consolidate and advance safety measures based on proven science.

“It’s a statewide initiative to use high-reliability science to prevent harm, and so we’ve been at it for a long time,” said Jennifer Jackson, CEO of the Connecticut Hospital Association.

For the first 10 years of the safety effort, hospitals worked on issues like improving communications between providers, empowering nurses and other staff to speak up when they suspected another clinician’s mistake.

“We practiced root-cause analysis, to go back to the safety event and look at process,” Ryan said. Studying past incidents sped up improvements like the automation of medication dispensing in hospitals, which helped reduce dosing errors.

The COVID-19 epidemic, however, upended newly established safety systems and brought on a set of new challenges including dramatic surges in staff turnover and violence in hospitals. Starting in 2023, a group of Connecticut health leaders decided to adopt a second phase of safety initiatives with a stronger emphasis on training new staff and engaging patients and their families.

The latest campaign is also exploring new approaches to persistent issues like hospital-acquired infections, pressure ulcers and falls, Ryan said. Nearly 100 health-care executives and providers gathered in February for a training session on the latest safety effort, called the High Reliability Organizations Forward initiative.

“Hospitals work together, and they share what they learn from errors,” Jackson said. “They share their implementation of the behaviors and how they’re keeping people safe.”

Telesitters watch for fall danger

A key element in making change in the modern health-care workplace is adopting new technology, Ryan said.

Virtual nursing, in which patients can interact with a nurse on-camera in their rooms, is being explored to ease staffing shortages and has been adopted in some markets. Introducing artificial intelligence tools into medical records systems allows for easier and more accurate record-keeping and can help speed a patient’s discharge from the hospital.

More recently, Yale researchers have developed an AI-powered triage platform to allow for quicker and more accurate treatment during a crisis like a surge in pandemic patients.

“I think eventually those supportive tools will help us,” Ryan said of AI and virtual reality innovations.

When it comes to falls, a video-monitoring device called a “telesitter” shows real promise in reducing dangerous incidents. The device “watches” from a fixed point in a room at all times and alerts a nurse when a patient attempts to get out of bed.

UConn John Dempsey Hospital in Farmington deployed telesitter carts in the hospital rooms of patients in November as part of fall-prevention efforts. The devices helped prevent two falls on the very first day of use, according to Project Manager Jason Cardona. Techs watching the monitors triggered alarms and nurses rushed to intercept vulnerable patients before they could put themselves in danger.

“It was great to see the impact this technology solution has on patient safety and the added value it brings to patient care,” Cardona said in a UConn Health post announcing the new technology.

A willingness to adopt new technology is part of the ongoing effort to institutionalize safety practices in Connecticut health-care businesses and work to reduce “never events,” said Jackson of the Connecticut Hospital Association.

“It’s a statewide culture,” Jackson said. “This is what our hospitals are about, our commitment to safety. We are never done trying to keep our patients safe.”

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