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Niagara Health employee’s curiosity spurs critical patient falls research

Posted Jul 6th, 2023

The research we conduct at Niagara Health has a profound impact on the health and well-being of our patients and communities, and contributes to better understanding some of the most significant healthcare challenges of our time and have the potential to benefit patients in Niagara and across Canada.

A woman sits at her desk with her hands on her laptop.

Decision Support Co-ordinator Virginia Pullar was recently recognized for her research about the increase in patient falls during the first wave of the COVID-19 pandemic. 

When Virginia Pullar first noticed there seemed to be an unusually high number of patients falling in the hospital during the early part of the COVID-19 pandemic, she immediately wanted to investigate it further.

Her initiative led to a research project that provides key insights about patient safety for frontline workers. Findings from the project, “Exploring Changes in Patient Safety Incidents During the COVID-19 Pandemic,” have been published in the Journal of Patient Safety.

That research also garnered Pullar recognition for her enterprising use of data. The Co-ordinator in Decision Support received the Dr. Johan Viljoen Staff Research Award in May during Niagara Health’s annual Research Day. 

“It was extra special because it was Dr. Viljoen presenting the award,” she says. “I admire him and what he's done for the organization. It was an honour.”

During the pandemic, Pullar worked with the Niagara Health Falls Committee collecting data from the Incident Reporting System (IRS). IRS is a process for frontline staff to report incidents within the hospital, including patient falls.  The committee expected to see a drastic drop in the number of falls, given the decrease in people entering the hospital during the pandemic’s first wave.  

“Most people were staying home,” Pullar says. “But when I actually looked at the data, it showed that we had more falls. We didn't expect that.” 

That led Pullar to investigate the data further. Thanks to Niagara Health being open to new ideas and innovative action, she quickly collaborated with members of the Anesthesiology Department and the Emergency Medicine Researchers of Niagara (EMRoN) team.

Having worked with this group of researchers in the past, Pullar says she wanted to take advantage of their experience in analysis and research writing. She knew they could apply the statistical model to fully understand if there was a significant change in the data. In addition, the team analyzed all of the data, not just falls, to see if there was anything else they could learn.

“Leveraging the research team’s statistical expertise, and my knowledge of the data set, it was just a really good fit, and it came together quite easily,” she says. Once the data analysis was completed, Pullar says it was just one piece of the puzzle.   

“It doesn't give you the answers as to what is actually happening,” she says. “You still need the qualitative piece. So, we talked to different staff and different teams across Niagara Health.” 

After all the information was gathered, Pullar took it back to the Falls Committee where it was theorized that visitor restrictions, and reduced patient contact and supervision may have had an impact on the number of patients falling. 

“We weren't going in and out of the rooms as frequently as we were before the pandemic because every time, you had to put on and take off your PPE,” she says. “So, maybe just the frequency of how we were interacting with our patients had an impact.” 

Overall, Pullar says the most important conclusion the data highlighted was the need for a rapid response and adaptability to unpredictable situations, particularly those that could arise during a pandemic. 

“Even if we experience something on a smaller scale, we will now know to think about causes for more falls as being a potential impact for some of our patients,” she says.

“When we saw that our internal medicine and complex care patients were the most at-risk in this scenario, it was really good to feed that information back to those frontline teams.” 

Pullar credits diligent frontline staff for reporting the falls in the first place.  

“It speaks to the culture of our organization, and the culture around safety, that staff are comfortable in reporting when things don't go exactly as planned with a patient. Then we can learn from it. That's how we change policy and process.” 

Pullar says she simply wanted to show IRS data is valuable for more than just day-to-day reporting. 

“We use the data a lot, but this was the first time we had ever imported it into an analytical model. It has the potential for us to get valuable information back to the frontline staff working directly with the patients.” What’s next? Pullar says the new hospital information system (HIS) and advancements in data collection will lead to improved patient experience. The HIS will also improve digital access for physicians and staff and increase communication between team members with real-time documentation sharing. 

“The more we can provide high-quality data in real time, the faster and more informed the decision makers, leadership, and frontline staff can be in making decisions for quality care and patient experience,” she says.

Niagara Health System