Aim: To explore factors influencing the implementation of a hospital fall prevention program, including considerations related to acceptability, sustainability and scale-up, from the perspectives of healthcare professionals involved.
Methods: Semi-structured interviews were conducted with 23 healthcare professionals involved in the design, management and/or implementation of a hospital falls prevention program across several hospitals. Participants were purposively sampled across multiple organisational levels and professional disciplines. Interviews were audio-recorded, transcribed and analysed using a hybrid deductive-inductive approach. Initial coding was guided by the i-PARIHS framework to understand the barriers and enablers to implementation, followed by thematic analysis.
Results: Preliminary findings indicated that effective implementation of the hospital-based falls prevention program was supported by strong visibility of falls prevention as an organisational priority, and strengthened through consistent communication, monitoring and governance oversight processes. Engagement improved when falls prevention was integrated into the existing workflows and local priorities (e.g., rounding, risk huddles, and governance and accreditation processes) and positioned as belonging to the frontline team rather than imposed ‘top-down’. Facilitation through mentorship, coaching and interdisciplinary support enabled knowledge sharing and adaptation to the local context. However, implementation and sustainability were limited by workforce pressures, competing priorities, limited protected time for reflection, and bureaucratic challenges, particularly for ward-level champions. Sustainability and scale-up were associated with flexibility, skill-based approaches embedded in existing systems and organisational cultures of continuous improvement.
Conclusion: Sustainable falls prevention may depend less on individual prevention strategies and more on facilitation that supports adaptation within routine clinical practice and organisational cultures.