From framework to frontline: Embedding enterprise risk management into emergency department fall prevention

TL;DR

This paper suggests integrating enterprise risk management into emergency departments to prevent falls by using available data and tools for early risk assessment.

Contribution

The paper extends an ERM framework to emergency departments and proposes using existing data for fall prevention.

Findings

High-risk indicators like anticoagulant use can be embedded into machine learning tools in EDs.

Fall-related injuries in EDs can lead to increased hospital stays and non-reimbursable costs.

Risk matrices and heat maps offer scalable safety prioritization in dynamic ED settings.

Abstract

This letter to the editor responds to Bailey and Delchamps’ recent article on integrating enterprise risk management (ERM) in fall‐related injury prevention. We extend their framework to emergency departments (EDs), emphasizing the strategic advantage of initiating individualized fall risk assessment at the point of triage. Many high‐risk indicators—such as anticoagulant use and cognitive impairment—are already accessible in ED settings and can be embedded into machine learning–supported tools like the Rothman index or fall triage score. We also highlight the financial implications of fall‐related injuries originating in or near the ED, noting their potential to increase hospital length of stay and trigger non‐reimbursable costs. The authors’ inclusion of risk matrices and heat maps presents scalable opportunities for safety prioritization in dynamic ED environments. We conclude by recommending prospective validation of ERM‐based approaches within level 1 trauma centers and invite collaboration to test the framework's effectiveness in real‐world emergency settings.