Relationship between information technology functionalities and hospital-acquired injurious fall rates in US acute care hospitals


The purpose of this exploratory study was to determine health information technology functionalities in inpatient care units that were associated with reduced fall risk among adult patients aged 65 years or older in acute care hospitals in the United States. This study compared the differences in the hospital-acquired injurious fall rates for hospitals in California, Florida, and New York with and without fully implemented IT functionalities in their general medical and surgical inpatient units. It used publicly available 2007 datasets, the hospital was the unit of analysis, and teaching and non-teaching hospitals were analyzed separately. Hospital-acquired injurious falls were identified based on fall-related primary and secondary diagnoses and were flagged by the hospitals as not “present on admission” in the 2007 California, Florida, and New York State Inpatient Database data. The 4 health IT functionalities in general medical and surgical inpatient units were 1) electronic clinical documentation, 2) results viewing, 3) computerized provider order entry, and 4) decision support. The research question was What are the effective health IT functionalities in the general medical and surgical units for reducing fall risk among adult patients aged 65 years or older at their hospitals? Independent t tests were used. The results showed that no significant difference was found in the hospital-acquired injurious fall rates between hospitals with and without each of the 4 functionalities and between the teaching hospitals with and without each of the 4 functionalities. Significant differences were found in the injurious fall rates between non-teaching hospitals with and without electronic clinical documentation and result viewing. Future research may focus on assessing the clinicians’ use of the IT functionalities of electronic clinical documentation and results viewing, as well as the effect of the clinicians’ use patterns on patient outcomes.

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Tzeng, H. , Hu, H. , Yin, C. and Kang, Y. (2012) Relationship between information technology functionalities and hospital-acquired injurious fall rates in US acute care hospitals. Open Journal of Nursing, 2, 104-110. doi: 10.4236/ojn.2012.22016.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Oliver, D., Healey, F. and Haines, T.P. (2010) Preventing falls and fall-related injuries in hospitals. Clinics in Geriatric Medicine, 26, 645-692. doi:10.1016/j.cger.2010.06.005
[2] McGowan, J.J. and Roper, R.A. (2010) The Health IT Value Grant Initiative: A programmatic review of the peer-reviewed literature. AHRQ Publication No. 10-0063-EF. Agency for Healthcare Research and Quality, Rockville.
[3] Dykes, P.C., Carroll, D.L., Hurley, A., Lipsitz, S., Benoit, A., Chang, F., Meltzer, S., Tsurikova, R., Zuyov, L. and Middleton, B. (2010) Fall prevention in acute care hospitals: a randomized trial. Journal of the American Medical Association, 304, 1912-1918. doi:10.1001/jama.2010.1567
[4] Tzeng, H.M., Hu, H.M. and Yin, C.Y. (2011) Is there a link between the hospital-acquired injurious fall rates in US acute care hospitals and these institutions’ implementation levels of computerized systems? CIN: Computers, Informatics, Nursing, 29, 721-729.
[5] Centers for Medicare & Medicaid Services (CMS) (2008) Changes to the hospital inpatient prospective payment systems and fiscal year 2009 rates.
[6] Healthcare Cost and Utilization Project (2011) Overview of the state inpatient databases (SID).
[7] American Hospital Association (AHA) (2008) Hospital EHR adoption databaseTM.
[8] American Hospital Association (AHA) (2008) 2007 AHA annual survey—Information technology supplement.
[9] Library of Congress (2010) The one hundred eleventh congress of the United States of America at the second section: The patient protection and affordable care act (H. R. 3590). US Government Printing Office, Washington DC.
[10] Stead, W.W. and Herbert, S.L. (2009) Summary. In: Stead, W.W. and Herbert, S.L. Eds., Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions. The National Academy of Sciences, Washington DC, S10-S11.
[11] Law, B. (2010) The Health Information Technology for Economic and Clinical Health Act (HITECH) Act.
[12] Jha, A.K., DesRoches, C.M., Campbell, E.G., Donelan, K., Rao, S.R., Ferris, T.G., Shields, A., Rosenbaum, S. and Blumenthal, D. (2009) Use of electronic health records in U.S. hospitals. New England Journal of Medicine, 360, 1628-1638. doi:10.1056/NEJMsa0900592
[13] National Quality Forum (NQF) (2010) Safe practices for better healthcare—2010 update: A consensus report. National Quality Forum, Washington DC.
[14] Coffey, R., Milenkovic, M. and Andrews, R.M. (2006) HCUP methods series report # 2006-01: The case for the present-on-admission (PoA) indicator.
[15] Csikesz, N.G., Singla, A., Simons, J.P., Tseng, J.F. and Shah, S.A. (2009) The impact of socioeconomic status on presentation and treatment of diverticular disease. Journal of Gastrointestinal Surgery, 13, 1993-2001. doi:10.1007/s11605-009-1031-3
[16] Dartmouth Atlas of Health Care (2007) Medicare reimbursements per enrollee, by gender and program component.,19
[17] American Hospital Association (AHA) (2008) AHA annual survey database for fiscal year 2007. Health Forum LLC, Chicago.
[18] Faul, F., Erdfelder, E., Buchner, A. and Lang, A.G. (2009) Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 1149-1160. doi:10.3758/BRM.41.4.1149
[19] Faul, F., Erdfelder, E., Lang, A.G. and Buchner, A. (2007) G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175-191. doi:10.3758/BF03193146
[20] Jha, A.K., DesRoches, C.M., Kralovec, P.D. and Joshi, M.S. (2010) A progress report on electronic health records in US hospitals. Health Affairs (Millwood), 29, 1951-1957. doi:10.1377/hlthaff.2010.0502

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