HD Nursing
Revolutionizing Patient Safety with Evidence-Based Fall Prevention

Dr. Amy Hester, Co-Founder, Chairperson and CEO, HD Nursing

At this point, Hester and her longtime colleague Dees Davis set out on their journey to better understand why their patients were falling—to support caregivers in minimizing the risks of fall-related negative care outcomes. Hester empathized, “The situation was dire enough that a patient was suffering from a brain tumor or a stroke. Then you lay a fall with injury on top of that, and it dramatically staggers their recovery and their journey toward discharge and wellness.” But as soon as Hester and Davis embarked on their mission to conduct extensive R&D into existing fall prevention strategies, they recognized that the clinical content and prevention strategies available at the time were inadequate. While the studies could assess a patient’s risk of falling with a simple ‘yes-or-no,’ it couldn’t support clinicians in evaluating the degree of that risk.

Hester and Davis then took it upon themselves to design an effective fall prevention offering capable of accurately predicting the risk of patient falls. Not long after, in 2010, Hester began pursuit of her Ph.D. and the two initiated clinical trials on their fall prevention program in the 30-bed neuro-service unit at UAMS.

The trials were a tremendous success, resulting in a significant reduction in fall rates and helping Hester, Davis, and the neuro-service unit nursing staff to improve their overall patient care outcomes. The impact of the program was implemented in other departments of the hospital, and other care managers also started utilizing the fall prevention program in their units. Consequently, UAMS climbed up the national patient safety benchmark while eliminating the need for one-to-one nursing staff in fall prevention, driving hospital cost savings to more than 1.5 million dollars in the first year. This incredible success resulted in Hester and Davis thinking about commercializing their program, which ultimately led to the formation of HD Nursing in 2012.

Today, HD Nursing is a designated Patient Safety Organization (PSO) by the Agency for Healthcare Research and Quality (AHRQ), and is recognized as the premier evidence based fall prevention program in the US healthcare marketplace. In 2021, the company introduced an additional prevention program, called the Braden Hester Pressure Injury Prevention Program©, to reduce pressure injury rates by delivering impactful, evidence-based risk and injury mitigation, just like it has done with fall rates. The backbone of both of these patient safety programs is its proprietary artificial intelligence (AI)-analytics software engine, called SenseAi. The company is currently close to reaching the major milestone of protecting patients across 50,000 beds in the country’s acute care, ICU and obstetrical patient populations, emergency departments, and other care units.

Transforming the Way Nurses Manage Patient Fall Rates

The comprehensive, individualized falls management program is comprised of evidence-based tools and services capable of reducing patient falls by accurately predicting at-risk patients, thereby generating personalized care plans to prevent injurious falls. Hester states, “We provide the right amount of care to the right patient at the right time.” The program can seamlessly integrate with all popular electronic medical record (EMR) systems, which drives faster detection of potential risks by nurses and more timely intervention in high risk cases. In essence, HD Nursing’s prevention programs are designed on three components: they “Predict, “Prevent” and “Sustain” positive patient outcomes.

One of the key features of the company’s fall prevention program is the Hester-Davis Scale (HDS) for fall risk assessment.

We offer a super effective analytics scoring tool called Our platform that monitors the specific use of our algorithms across client care facilities to track their overall compliance with our programs

In addition to its predict and prevent components, HD Nursing’s fall prevention program offers sustainability services, including curated support material and clinical content specially compiled to ensure nurses follow the company’s program and continue to reap its long-term savings and performance boosts. The company recognizes that the current healthcare arena is constantly evolving. Hester states, “We update our sustainability content every two years to continually educate its users on the latest and most impactful ways to establish and maintain evidence-based fall and pressure injury prevention.” To further boost the impact of its sustainability services, HD Nursing assigns a dedicated sustainability coach for each customer. These coaches assist and direct nurses to properly handle their documentation workflows while supporting them in transforming the way fall and pressure injury prevention initiatives are handled at their facilities. HD Nursing also conducts quarterly touchpoint evaluations of its clients’ performance and helps them maintain high-quality patient outcomes.

Applying the Same Approach to Reduce Pressure Injuries

Another key offering in HD Nursing’s patient safety portfolio is its highly touted Braden Hester Pressure Injury Prevention Program. This program was designed in collaboration with Drs. Barbara Braden and Nancy Bergstrom, the two authors of the Braden Scale—the gold-standard used globally to predict pressure injury risk. Once the risk is accurately evaluated, nurses can then utilize the pressure injury prevention program’s innovative Braden-Hester care plans as well as dedicated Braden-Hester support materials to manage pressure-related injuries. Clients can also implement the Braden-Hester pressure injury analytics bundles to help prevent future pressure injuries.

Von Cameron, Chief Revenue Officer & Dr. Erin Bush, VP of Clinical Operations & Dr. Amy Hester, Chairwoman and Chief Executive Officer & Robin Lepire, Enterprise Project Manager & Rosalie Lucas, Physical Therapist and Clinical Consultant & Dr. Patricia Quigley, Clinical Advisory Committee & Kent Barkouras, President, HD Nursing

SenseAi acts as the backbone for both prevention programs and provides reports to nurses that allow them to benchmark their fall and pressure injury prevention performance against national standards. This opens up avenues to detect the sources of their inefficiencies within care units and mitigate those to boost care performance and workforce productivity.

Moving toward End-to-End Patient Safety

With such unmatched core competencies, HD Nursing has ignited several success stories throughout its decade long journey in the healthcare sector. In one instance, the company assisted a faith-based healthcare organization to significantly minimize their fall prevention rates across their extensive four state-spanning geographical footprint (Illinois, Wisconsin, Missouri, and Oklahoma). As an organization with a fragmented footprint, the customer was struggling to gain an accurate assessment of their fall prevention initiatives and their impact on the overall performance as a patient care firm. With HD Nursing’s Fall Prevention program and data analytics capabilities, the client was able to educate their caregivers with best suited approaches, accurately predict their fall rates across facilities, and develop care plans that perfectly aligned with the unique needs of each hospital. At the end of HD Nursing’s implementation, the customer was able to reduce falls by 50 percent and injuries by 75 percent, which led to savings of up to $5 million. This example illustrates that if a care facility maintains compliance and applies the practices offered by HD Nursing’s fall prevention program and its ever-updating sustainability services, they are likely assured to realize transformative reductions in their overall fall rates and fall-related costs.