Fall Risk Model Validation

With active and ongoing research, there is simply no other fall risk tool that has been validated in as many patients, at as many diverse sites of care, and with longer duration of study than the Hendrich II Fall Risk Model®. Our research continues with our research partner, BioRankings of St. Louis.

We have helped many of the largest healthcare systems across the United States achieve some of the lowest fall injury rates in the industry.

Total Falls Studied
Total Falls Studied Chart

Hendrich II has studied more than 1,000+ falls in diverse sites (geography, size, and type of facilities) for ongoing model validation and psychometrics

Total Non-Falls Studied
Total Non-Falls Studied Chart

Non-falls (controls) from large, consecutive, diverse patient types enabled rigorous testing of Hendrich II risk factors with patients who had multiple diagnoses and were admitted to the same facility during the same time span as described in this National Institute of Health reference: Epidemiology in Practice: Case-Control Studies

Hendrich II
HD Nursing
Johns Hopkins
Morse

A Comparison of Fall Risk Tools in the Peer-Reviewed Literature

Model
Development
Hendrich II
Fall Risk Model
Hester DavisJohns HopkinsMorse
Multisite study in tool development and testingNoneNone
Diversity of facility size and typeCritical access through Level 1 Trauma; 25-1,120 beds; skilled nursing, behavioral health, critical care, emergency departmentOne 30-bed neuroscience unit in one hospital18 units in tertiary hospital1,200 beds, including long-term care, Veterans home; 240-bed rehab hospital
Physical Assessments of patientsResearch RNs completed physical exams with standardized instruments to test more than 600 risk variables in 355 falls and 780 randomized non-fallsScale items selected subjectively through literature review rather than physical assessment of patientsScale items selected and weighted subjectively based on literature review and group consensus rather than physical assessment of patientsPhysiological variables were collected for 100 falls and 100 nonfalls through chart review and physical examination
Length of study2- and 3-year studies10 months14 months4-5 months
Sensitivity Prediction accuracy78-90+% based on cut-off score in 214,000 patients at nine sites with an extremely low fall rate of .29% using Hendrich II Fall Risk Model90% in one hospital with 1,904 patients tested87.4%78% (1989)
Specificity Correctly identifies low risk who did not fall*64+%

*The low fall rate in the population over the 3-year study results in underestimation of both psychometrics, indicating very high statistical performance
47.1%28.1%83% (1989)
Validation2003, 2020NoneNoneNone
Multisite study in tool development and testing
Hendrich II Fall Risk Model
Hester DavisNone
Johns HopkinsNone
Morse
 
Diversity of facility size and type
Hendrich II Fall Risk ModelCritical access through Level 1 Trauma; 25-1,120 beds; skilled nursing, behavioral health, critical care, emergency department
Hester DavisOne 30-bed neuroscience unit in one hospital
Johns Hopkins18 units in tertiary hospital
Morse1,200 beds, including long-term care, Veterans home; 240-bed rehab hospital
 
Physical Assessments of patients
Hendrich II Fall Risk ModelResearch RNs completed physical exams with standardized instruments to test more than 600 risk variables in 355 falls and 780 randomized non-falls
Hester DavisScale items selected subjectively through literature review rather than physical assessment of patients
Johns HopkinsScale items selected and weighted subjectively based on literature review and group consensus rather than physical assessment of patients
MorsePhysiological variables were collected for 100 falls and 100 nonfalls through chart review and physical examination
 
Length of study
Hendrich II Fall Risk Model2- and 3-year studies
Hester Davis10 months
Johns Hopkins14 months
Morse4-5 months
 
Sensitivity Prediction accuracy
Hendrich II Fall Risk Model78-90+% based on cut-off score in 214,000 patients at nine sites with an extremely low fall rate of .29% using Hendrich II Fall Risk Model
Hester Davis90% in one hospital with 1,904 patients tested
Johns Hopkins87.4%
Morse78% (1989)
 
Specificity Correctly identifies low risk who did not fall
Hendrich II Fall Risk Model*64+%

*The low fall rate in the population over the 3-year study results in underestimation of both psychometrics, indicating very high statistical performance
Hester Davis47.1%
Johns Hopkins28.1%
Morse83% (1989)
 
Validation
Hendrich II Fall Risk Model2003, 2020
Hester DavisNone
Johns HopkinsNone
MorseNone
 

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