Hear Peggy Maguire speak about why reducing falls by 80% at AdventHealth’s inpatient units — through her scalable education program — mattered to her.

The American Society for Health Care Risk Management (ASHRM) awarded the 2024 Innovation Award, sponsored by RLDatix, to AdventHealth Dade City and AdventHealth Zephyrhills, for their work in reducing patient fall rates and creating culture change. 

“We really had tried everything,” said Peggy, the Director of Risk Management at AdventHealth. “Like most hospitals — trying one thing after another and just nothing seemed to really have traction.” 

Peggy started delving deep into patient safety organization assessments to explore new methods of vulnerability detection. It encouraged her to analyze their event data closer. 

Predictive Modeling 

Her team began gathering and analyzing data trends in summer 2022. Among many insights, they discovered: 

They modeled these insights to determine their highest-risk patients. On Tuesdays and Fridays, they connected with nurse managers to identity the three highest-risk patients, sharing their names, room numbers and reasonings. It has become a daily task at their leadership safety huddles. 

Within four months, their falls decreased by nearly 10%. “We thought we could do better,” said Peggy. “So the idea of a bootcamp was born.” 

Innovative Healthcare Education 

"It's a high-intensity model.” 

They held their first bootcamp in January 2023, exclusively for inpatient nurse managers and assistant nurse managers. The three-hour session featured four activity-based components: 

• Fall risk scale model
• Nurse-patient communication 
• Gait belts
• Mobilizing patients 

“The sky was the limit. Truly the goal was zero harm. We weren't sure if that was fully realistic, but we wanted to get as close as possible. Bootcamps are a different kind of education. In the hospital, we're used to watching a video and then clicking ten questions and answering them ... Sometimes we'll attend an in-person class, but it's all theoretical or just talking about safety standards. It's informational. We wanted to add the active component.” 

The bootcamp concluded with goal-setting and takeaway plans. 

“Whether it's fitness or military for six weeks, there's always intense focus and there's always a relentless pursuit for excellence and there's a goal that is challenging. If it were easy, it wouldn't be a bootcamp, so we wanted to incorporate all of those aspects. 

Data-Driven Healthcare Decision-Making 

“Predictive modeling helped us become mindful of fall risks on a daily basis ... The more data you can accumulate to help you predict, your target focus will be even better.” 

Peggy knew she needed to sustain the new enthusiasm and momentum before the next bootcamp. They followed with educational videos and created an employee role who would champion fall reduction. Within four months, their falls were 50-80% lower than last year. 

They held a second bootcamp, for only direct care staff, joined by two moderators: Chair of Patient Falls Committee and Director of Special Projects. They already had a plan for each unit, so the moderators and Peggy only need to modify the agenda to add: building partnership skills for physical therapy. This second session led to their falls “plummeting” to an all-time low. For any subsequent inpatient unit increase, they implemented a three-day deep dive which has brought those respective rates back down. 

“We closed 2023 with some amazing fall rates and truly had seen a culture change.  What’s even better is that 2024’s rates are lower still.  We are at the point where what we do every day — the comprehensive plan — has become a habit. It’s just what we do.  

Now, they hold a bootcamp every six months, adding ancillary staff, including the environmental services (EVS) lab team. 

Fostering a Culture of Data for Continuous Improvement and Zero Harm 

Data is what Peggy believed is the first step for healthcare leaders striving for similar results. 

“Start with the foundation of predictive modeling with your trending data. Looking at hard numbers and comparing over time, analyzing and not just collecting, making a change based on what your analysis shows you — this helps get everyone on the same page and in the same mindset. Then with this as a solid foundation, move forward with holding a bootcamp.” 

She advised healthcare leaders to share insights at the team level, and then to turn these insights into actions that become ingrained routines. Peggy attributed the bootcamp’s success to culture change, ownership and accountability. 

Today, after an 80% fall reduction, Peggy wants to do more with data. 

“We're only collecting what is obvious to us. I think there's a whole other layer of the less obvious that really could make an even bigger difference. That's where that data analysis would come in and be a big driver to even greater improvement.” 

To learn more about transforming your risk and safety management with event data reporting and analysis, book a meeting with our team today.

Peggy Maguire, RN JD. CPHRM, serves as Director of Risk Management for two Florida hospitals in the AdventHealth system. She began her career as an RN working in critical care and dialysis, then after 10 years in nursing she returned to further her education in law school where she obtained her Juris Doctor degree. Having worked as both an RN and an Attorney, she found that the combination of both backgrounds serves her well in the risk management profession. 

As Director of Risk Management she is proud to have developed risk reduction strategies that reduced adverse events to near zero harm levels in both surgery and emergency departments. She seeks creative, “outside the box” solutions to support engaging and sustained culture change.   

Peggy is a published author, having written a critical insider’s look at managed care which was published in the Capital University Law Review. She is also a co-author of several healthcare statutes and administrative rules for the state of Ohio and has presented on numerous medico-legal topics in a variety of settings.