Using the DIAL-F systems model as the conceptual framework for an audit of in-patient falls resk management

Most interventions for managing (reducing) the risks associated with in-patient falls have used a clinical approach to address underlying frailty and illness (physical and mental) with drugs, technology and therapy. This paper reports the results of a two stage audit on in-patient falls risk management at two teaching hospitals in the UK in July 2013 using the DIAL-F systems model as a Human Factors/Ergonomics (HFE) conceptual framework to explore patient engagement with falls risk management. Some safety critical system misalignments were found, and it is suggested that a future HFE intervention might include addressing the problems of (1) reach distances to walking aids and (2) obstacles in the bedside area for patients needing mobility assistance.