I know everyone is focused on designing for safety to prevent the spread of the virus that causes Covid-19 right now, but I want to bring up another public health hazard that's influenced by the environment: falling.
Why am I thinking about this now?
Well, my 87-year old mother fell and broke her hip this week. A friend's 76-year old mother also recently fell and broke her hip. Both accidents occurred in or around their residences.
Leading Cause of ER Visits
According to facts gathered by the National Floor Safety Institute, falls account for over 8 million hospital emergency room visits each year in the U.S. and are the leading cause of ER visits by people of all ages.
People already in the hospital take tumbles, too. The Agency for Healthcare Research and Quality reports that between 700,000-1,000,000 people in the U.S. fall in a hospital each year.
Falls are also the second leading cause of injury-related death for people who are 64-84 years old, and the leading cause of injury-related death for those who are 85 years or older. Over 60 percent of nursing home residents in the U.S. fall each year. And half of the people over the age of 65 who are hospitalized for hip fractures cannot return home or live independently after the fracture.
Unfortunately, that will be the case for my mom. My friend's mom has recovered and is expected to gain full mobility.
Complex Problem
Falling is a complex problem to solve, however, because there are many social, physiological, cognitive, and environmental factors that cause slips and falls to happen in homes, schools, healthcare and residential care facilities, offices, and factories.
But it's important to keep in mind that floors and flooring materials are a major cause of fall-related injuries across all ages and in all types of buildings. According to the Consumer Product Safety Commission, they contribute directly to more than two million fall injuries in the U.S. each year.
A big culprit is uneven transitions between different flooring types. Other environmental factors that affect flooring's ability to contribute to falls are lighting, patterns, and glare. Product attributes like slip-resistance and hardness are also an issue.
Latent Variables in the Environment
Besides flooring and lighting, The Center for Health Design has identified other variables in the hospital environment that can contribute to falls:
- Bedrails and other restraints
- Door openings
- Furniture height
- Environmental obstacles
- Bathroom design
- Noise
- Room layout
- Nursing station layout
- Medical vigilance system
This all may be old news for you seasoned healthcare designers and facility planners, but it's always a good idea to think about it again and keep pushing the envelope to come up with new ideas to reduce the risk of falling.
New Technologies for Products
And what about product design? Are there new technologies that can be used in creative, affordable ways to help prevent falls?
Yesterday, my car flashed a BRAKE warning sign in my windshield when I got too close to the car in front of me. How about a chair that will give a warning if a person is about to make a bad choice to stand up or sit down? Or a floor that vibrates to signal a transition?
Maybe those products already exist. I don't know.
But what I do know is that unlike the coronavirus that causes Covid-19, falling is a safety issue that's never going away.
Want to Know More?
Check out these resources:
Preventing Falls in Hospitals: A Toolkit for Improving the Quality of Care, Agency for Healthcare Research and Quality.
Safety Risk Assessment Tool, The Center for Health Design.
Healthcare Environmental Terms and Outcome Measures: An Evidence-based Design Glossary, The Center for Health Design.
Achieving EBD Goals Through Flooring Selection and Design, The Center for Health Design and Tandus Flooring.
Insights on Wellness: Flooring and Safety, EF Contract.
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