New England doctor fears restraints will be used in preventing patient falls

Accreditation Connection, June 8, 2009

In October 2009, the federal government stopped paying hospitals for extra care if a patient fall was deemed preventable, according to However, Dr. Sharon K. Inouye of Harvard Medical School believes patient falls to be an intractable problem and should not be included on a list of avoidable medical errors. One of every five patients falls during their stay, reports The Globe.

Inouye believes restraints will be used to help prevent patients from falling, but could potentially lead to greater harm on the patient, and reverse a trend of greater mobility among hospitalized patients. "We have to do something to counteract what may be people's natural tendency to think to stop falls," says Inouye. "We want to open people's eyes to the fact that restraints are actually associated with lots of complications."

For more than 20 years, as the director of the Aging Brain Center at the Institute for Aging Research at Hebrew Senior life, Inouye has studied ways to prevent delirium, which occurs most often when patients are restrained. She determined that by minimizing certain medications, maintaining mobility, and using lower beds with scheduled trips to the toilet, falls can be reduced.

Dr. Thomas Valuck, medical officer and senior adviser at the Center for Medicare Management at the Centers for Medicare & Medicaid Services told he believes Inouye's policy encourages alternatives to restraints and it "is appropriate to use the Medicare payment incentive to encourage adherence to those best practices."

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