When Dr. Steven Mulder first heard about the statewide project -- to prevent patients from falling in Minnesota hospitals -- he was skeptical.
"My reaction was, well, this is all well and good," said Mulder, the CEO of a 66-bed hospital in Hutchinson, Minn. "But people get old and have poor balance and they're going to fall, and there's really not a lot we can do."
That was before the staff on the medical/surgical unit at Hutchinson Area Health Care decided to give it a try. The goal at most participating hospitals was to go 60 or 90 days without a fall.
Last year, Mulder's hospital went 308 days.
Their secret was a lot of little changes, said Dana Ratike, the clinical nurse leader. On her unit, many patients are considered "fall risks" because they've just come through surgery, or have pneumonia, or take medications that make them light-headed. The first step was to make sure that everyone -- from doctors to family members -- knew who those patients were, so they could keep an eye on them.
Among other things, they gave those patients red slippers, so they would be easily spotted if they were walking down the hall alone. The staff put "Falling Stars" and stop signs on patient doors, telling visitors to alert the staff before they leave.
They even posted calendars to track the number of days without a fall, which helped to unify the staff around the goal, Ratike said.
"Every time we got to a landmark -- 50 days, 100, 150, we had a plan for how we were going to celebrate," she said. The rewards were small -- movie tickets, Dairy Queen treats -- but everyone took pride in the achievements, she said.
The streak was broken after 10 months, but so far in 2012, the unit has had only two falls, she said, neither serious.
That's down from 27 falls in 2001.
"When you look at that 10-year graph, it's absolutely amazing," Mulder said. "The reduction is really quite dramatic."