Ward 7 is an acute medical ward within Dr Gray’s Hospital. Staff on the ward care for some of the most complex patients within the hospital. As with all other acute hospital wards, Ward 7 is challenged with improving the quality of care that it provides – which includes reducing falls and associated harm. There had been several previous attempts to reduce the number of falls, but no sustainable change. This improvement project set out to establish common causative factors of falls and to target improvement ideas appropriately.