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Quality Standard Details
Falls in Adults: Care in All Settings
- Publication Date
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2026-September-10
- Status
- Published
- Topic Area
- Injuries, Accidents and Wounds
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A fall is an unexpected event that results in a person inadvertently coming to rest on the ground or a lower surface, with or without injury. The prevalence of falls increases with age and is the leading cause of preventable injury-related hospitalizations (85% of cases) among older adults (aged 65 years and older) in Canada; falls are also the leading cause of unintentional injury-related deaths globally. Approximately 20% to 30% of older adults in Canada report falling yearly.
In Ontario in 2024, the rate of emergency department visits for falls in older adults was nearly 6,000 falls per 100,000 people, and the hospitalization rate was almost 1,500 per 100,000 people. The average length of hospital stay for older adults who have had a fall is four to five days longer than for those hospitalized for injuries due to any cause.
This quality standard addresses care for adults aged 18 years and older who have experienced a fall or who are at risk of falling, with a focus on older adults, aged 65 and older, and their care partners. It addresses care provided in all health care settings, including acute care, emergency, primary care, regional geriatric program, long-term care, palliative care and other home and community care settings, as well as referral to specialized care. Some statements may also apply to care provided in rehabilitation, behavioural support or specialized geriatric settings. Some statements may also apply to the care of people with disabilities; however, this quality standard does not address the unique needs of people with disabilities who have experienced a fall or who are at risk of falling.
This quality standard does not address the treatment of comorbidities. However, it can be used alongside existing Ontario Health quality standards to address the needs of people who have comorbidities such as dementia (experienced in hospitals and long-term care homes or in the community), delirium, or hip fracture, as well as the needs of those requiring palliative care or transitioning between hospital and home.
Frailty is common in older adults who have experienced a fall or who are at risk of falling. For further information on the care of people with frailty, see Ontario Health’s Frailty in Adults quality standard.
Quality Standard in Brief
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Quality Statement 1: Identification of Individual Fall Risk
Older adults and other people at risk of falls have their individual fall risk identified routinely during health care encounters.
Quality Statement 2: Comprehensive Assessment
People at high risk of falls, including all hospitalized older adults, are offered a comprehensive multifactorial fall-risk assessment. The assessment is completed by a clinician or interprofessional care team and informs the development of an individualized care plan.
Quality Statement 3: Comprehensive Interventions to Prevent Falls
People at risk of falls are supported with tailored, multicomponent interventions. An individualized care plan is developed collaboratively and shared with the person, their care partners, and their clinician or interprofessional care team. The plan addresses the fall risk identified in the comprehensive assessment. It also includes education about falls prevention, interventions to prevent injuries and fractures, and referrals to the appropriate levels of rehabilitative care as needed.
Quality Statement 4: Multicomponent Falls Prevention Exercise Program
People at risk of falls are supported to participate in an individualized, evidence-informed, multicomponent falls prevention exercise program. Exercise sessions occur at a frequency of 2 to 3 times a week. Exercises are progressive and guided by the person’s individual fall risk, goals of care, capabilities, and functioning.
Quality Statement 5: Structured Medication Review
People at risk of falls receive a structured medication review to identify polypharmacy and the use of fall risk–increasing drugs. The benefits and risks of each medication are evaluated and discussed with the person and their care partners. A shared decision is made to gradually reduce, change, or discontinue medications as appropriate.
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Placemat for this quality standard
A quick-reference resource for clinicians that summarizes the quality standard and includes a care pathway and links to helpful resources and tools
Quality improvement tools and resources for health care professionals, including an action plan template
Additional Resource
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- Summary of the public feedback we received
Last Updated: June 26, 2026
