Fall prevention in long term care

Observations watched how patients navigated hallways and got a glimpse at room layouts

The project sponsor informed us that the majority of falls in the facility took place in patient rooms. Unfortunately, we were unable to interact with any older adults in the facility so it was difficult to see what behaviour was like in the rooms. However, site staff and secondary research gave some insight into how falls might happen in the rooms.

Watching the hallways gave insight into how patients move throughout the hallways, but also how staff monitor and interact with patients.

The information gathered from observations was compiled, then reviewed for and grouped by themes.

Interviews with site staff identified expanded on what we saw and helped us form guiding principles for our recommendations

Talking with the staff allowed us to fill gaps in our knowledge and verify our observation findings. These interviews were short and semi-structured, often requiring us to meet the staff on a break or in between appointments with residents. >Following the interviews, we met as a class and discussed the findings so far.

The themes from the findings and resulting discussion were distilled into a guiding principles to inform our design suggestions:

• Prioritizes community & inclusion while promoting independence
• Communicates function & use clearly & effectively
• Prioritizes capacity over deficit to empower users
• Emphasizes flexibility without compromising dedicated use of space
• Recognizes the risks & opportunities created by the environment
• Provides scalable options & minimizes impact to operations when implementing changes

Giving residents a sense of agency & citizenship was the focus of our recommendations

Since falls are unpredictable, and the staff informed us that this mostly happens in the rooms, the team I was on made recommendations to give the patient more agency and control over their environment. Patients may withold information from staff members if they feel that it will threaten their autonomy. Giving residents a sense of agency will help them open up to the staff, as well as create a sense of calm and reduced frustration with their new environment.

Our recommendations and process can be found in detail here.

The final recommendations identified which of the guiding principles they covered, as well as an estimated feasibility of the specific recommendation.

• Use of a virtual reality tour for incoming residents to form mental maps of their new space and become familiar with it before they move in.
• A "buddy program" to pair newer residents with older residents to strengthen social learning and help build connections.
• Creating a set of "placement zones" to help organize the residents room. Drawin inspiration from retail spatial design, important objects should be placed in areas of high traffic and visbility
• Enhancing the wayfinding system in the building to help residents navigate spaces on their own. With less effort being put into figuring out where they are, the resident can put more focus on fall hazards.

The recommendations were presented to a multidisciplinary audience and we fielded questions from anyone interested