Contribution of the Designed Environment to Fall Risk in Hospitals

The vast majority of fall-reduction interventions are multimodal, addressing both intrinsic and extrinsic factors. Because it is often not feasible to make significant environmental modifications to the built environment once it is built, many of the extrinsic factors included in research tend to be more related to environment-in-use variables. There has been very little research that systematically examines the role of characteristics of the built environment such as room and unit layout, relationship of the bed to the bathroom, or layout and features of the bathroom on falls. Crosssectional analysis of 27 units in 12 hospitals using archival fall data identified a number of design characteristics that were associated with greater or fewer falls, including visibility to staff work spaces, presence of a dedicated family space in the room, bathroom layout and supportive features, and more. This project lays the foundation for a prospective study that will more directly link falls with specific environmental characteristics.