A system to detect fall occurrence and location in hospital settings

Project Summary/Abstract Problem Fall detection, assessment, and prevention is a challenging issue for healthcare institutions. Despite wide recognition as a considerable problem, fall-related injuries are the most frequently reported adverse events in hospital inpatient settings|up to 20% of patients fall at least once during their stay. According to the Agency for Healthcare Research and Quality reports, 30% to 51% of falls result in injury, and up to 44% of those injuries lead to death. In the United States alone, the number of inpatient falls exceeds 1 million per year, with elderly individuals being the most vulnerable. As a testament to its importance, fall research was listed as a top priority in the Institute of Medicine's report to Congress on national priorities.Diverse factors contribute to falls: patient factors (e.g., cognitive state, muscle weakness, medications), environmental factors (e.g., bed/toilet positioning, trip hazards), and institutional factors (e.g., poor respon- siveness to bed/chair alarms, inadequate fall assessment and prevention measures). Although hospitals employ programs to prevent falls, an essential component of a fall prevention program is accurate determination of fall events, as many falls are \unseen" and unreported. In their 2016 Claims Report, insurance company CNA stated that 66% of falls were unwitnessed and cited failure to monitor for falls in over half of closed legal claims. Alternative fall detection solutions have not been adopted in hospital settings due to poor fall sensitivity, high false-alarm rates, and lack of necessary supporting functions. Solution The body-worn FallCall system, proposed herein, will leverage powerful, novel sensing capabilities to provide robust fall detection and to report fall location without bothersome false alarms. The FallCall body-worn instrument will embody a miniature electronics package that is encapsulated in a disposable, hypoallergenic adhesive patch. The patch can be placed anywhere on the torso or upper arms to minimize interaction with other medical equipment or injury sites. The system will continuously monitor patients and issue a timely alert if a fall is detected, minimizing patient time on the ground, as well as injury assessment and treatment latencies.The FallCall system will allow patient location to be determined (including the room and oor of the hospital) using a reliable, robust wireless mesh network. Additionally, the FallCall system will have the capability to issue wander and inactivity alerts. The proposed system will be unique in its ability to objectively measure the response time of clinical sta when a fall occurs, and will be a key component in evaluating and improving fall prevention programs. Phase I Results The Phase I e ort built and evaluated the FallCall prototype in both a fall laboratory and real-world hospital setting using patients. The studies resulted in 100% of falls detected with zero false alarms. Location determination also achieved perfect accuracy. A formal usability study was conducted resulting in a grade in the top 5% based on normative data.