Patient Safety, Human Factors & Ergonomics, and Design: The Environment as a Larger-Scale Strategy to Reduce Falls

Falls are a key consideration for patient safety and play a prominent role under US legislation for affordable care. The built environment can either enhance safe practices and policy or act as an impediment for safe patient care. Falls are associated increased length of stay in hospitals and higher healthcare costs due to additional care, discharges to institutional care and litigation claims. With an increased focus on reimbursement related to patient safety as part of healthcare reform in the USA, organizations are becoming more aware of their own shortcomings and grappling with solutions to improve performance – typically people and processes. Yet the influence of the built environment, the space in which care is provided, can act as a barrier or enhancement to achieving the desired results – physically, cognitively, and organizationally. This paper presents the results from a mixed methods literature review on healthcare facility environmental design and falls. It is part of on-going research for the development of a Safety Risk Assessment (SRA) tool to promote discussion for proactive decision-making during the design of healthcare facility projects.