A 65-week, 12-ward stepped-wedge cluster randomised controlled trial across five Australian hospitals will test whether the Safe Recovery Program — structured falls-prevention education delivered by supervised allied health assistants and reinforced by trained ward staff — reduces falls per 1,000 patient bed days compared to usual care. Secondary outcomes include injurious fall rates, patient and staff knowledge shifts, and implementation barriers. An embedded economic evaluation will estimate incremental cost-effectiveness.
Hospital falls represent one of the most persistent and costly patient-safety failures in acute care, contributing to fractures, functional decline, prolonged admissions, and mortality in older adults. Despite decades of research, systematic patient education remains inconsistently deployed — a gap this trial directly targets. The train-the-trainer model and falls-champion structure are pragmatic design choices that, if effective, could scale without requiring specialist staffing at every bedside. The stepped-wedge design is analytically powerful for implementation research, allowing each ward to serve as its own control while accommodating real-world rollout constraints.
Critical caveats apply. This is a protocol paper only — no outcome data yet exist. Cluster designs risk contamination between wards, and patient-education trials are notoriously difficult to blind. Generalisability beyond Australian acute-care settings is uncertain. Most importantly, this is a preprint posted to medRxiv and has not yet undergone peer review; the methodology described here may change before publication. The trial is incremental rather than paradigm-shifting, but rigorous execution could meaningfully inform falls-prevention policy across hospital systems globally.
