Fall Risk Prediction Models During the Initial COVID-19 Surge: Could Predictive Analytics Be Used in a Resource-Constrained Environment?

During the first COVID surge, multiple changes in nurse staffing and workflows were made to support care delivery in a resource-constrained environment. We hypothesized that there was a higher rate of inpatient falls during the COVID surge. Furthermore, we predicted that an automated predictive analytic algorithm would perform as well as the Johns Hopkins Fall Risk Assessment. A retrospective review of falls for 3 months before and the first 3 months of the first COVID surge was conducted. We determined the total number of falls and the overall fall rate and examined the distribution of scores and accuracy of fall predictive models for both groups. There was a statistically significant increase in fall rate during the first 3 months of the COVID surge compared with the 3 prior months (2.48/1000 patient-days vs 1.89/1000 patient-days respectively; P = .041). The Johns Hopkins instrument had a greater sensitivity of 78.9% compared with 57.0% for the predictive analytic model. Specificity and accuracy of the predictive analytic model were higher than the Johns Hopkins instrument (71.3% vs 54.1% and 71.2% vs 54.3%, respectively). These findings suggest that the automated predictive analytic model could be used in a resource-constrained environment to accurately classify patients' risk of fall.