The Evolution of Injurious Fall Reduction and the Promotion of Healthy Aging

Hendrich Research, HII Risk Factors, Outcomes & Aging

Beginning in 2007, the American Journal of Nursing and the Hartford Institute for Geriatric Nursing collaborated on a series called “How to Try This,” offering multimedia content on evidence-based tools and best practices in geriatric care for the nursing community. The project received grant support from The John A. Hartford Foundation

One of the earliest entries in the series was Predicting Patient Falls, which features an educational article and a video to educate nurses on how to use the Hendrich II Fall Risk Model® in clinical practice. “Try this” content about the Hendrich II Fall Risk Model, including a case example about an 80-year old woman with new onset confusion and urinary incontinence, also appeared in other publications, such as the Annals of Long-Term Care.

Fast-forward to 2020, and the reduction of modifiable fall risk factors has never been more urgent. The rate of death from falls among persons 65 or older increased 31% from 2007 to 2016. In the years since the publication of the “Try this” resources, the Hendrich II Fall Risk Model has continued to demonstrate its ability to predict and reduce injurious falls in diverse populations within complex health care ecosystems, appearing in numerous peer-reviewed articles and validation studies in the United States and abroad.

Yet, a valid fall-risk assessment tool, as part of a comprehensive patient assessment, is only the first step in effective fall prevention and the promotion of healthy aging. A state-of-the-art injurious fall prevention program demands that the assessment tool be used correctly and consistently by interprofessional teams and that its use leads to specific interventions that target the modifiable root causes of a person’s fall risk, supporting a holistic approach to healthier aging. In short, it demands that an organization reimagine its culture around how fall reduction is achieved.

Connection to Hendrich II Fall Risk Model

The Hendrich team has evolved its support resources to offer a comprehensive foundation for a state-of-the-art fall prevention program. These resources include:

  • Dynamic and interactive, contact-hour approved online education for use of the Hendrich II Fall Risk Model for registered nurses and assistive personnel, with nurses teaching nurses from patient scenarios.
  • A case-study driven clinical resource guide that shows the model in action, with fall risk factors connected to evidence-based care pathways and plans that target the root causes of a person’s fall risk.
  • Toolkits to support rapid adoption and sustainment of the program, including methods, techniques and tools for change management, quality improvement/project management, and the creation of a culture of safety. 
  • A customizable map for building risk factors and care pathways and plans into any electronic health record.

As we enter a new decade, with a rapidly changing health care landscape, state-of-the-art fall reduction must integrate seamlessly with cross-continuum, person-centered care models, improving the health of persons in our communities and bolstering the quality and financial performance of health care organizations. The Hendrich II Fall Risk Model has evolved to offer the resources needed for organizations to achieve these objectives.


Burns, E. & Kakara, R. (2018). Deaths from falls among persons aged ≥65 years—United States, 2007-2016. Morbidity and Mortality Weekly Report, 67(18), 509-514. doi:

Gray-Miceli, D. (2007). Fall risk assessment for older adults: The Hendrich II Model. Annals of Long-Term Care, 15(2). 

Hendrich, A. (2007). Predicting patient falls: Using the Hendrich II Fall Risk Model in clinical practice. American Journal of Nursing, 107(11), 50-58. doi:10.1097/01.NAJ.0000298062.27349.8e

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