This writing discusses lessons learned from Sweden's efforts to put the World Falls Guidelines (WFG) into practice. The WFG is a set of expert recommendations designed to help prevent falls, particularly among vulnerable people. The success of such efforts is often decided at the organizational level of healthcare.

Healthcare systems can be thought of as having three levels. The "macro" level is where policies are made, such as by government or international bodies. The "micro" level is where care is delivered by clinical staff, like doctors and nurses, to patients. In between is the "meso" level, which consists of the organization's middle management.

While there is often support for new guidelines at both the high-level policy (macro) and frontline clinical (micro) levels, the middle management (meso) level can become a roadblock. This happens when managers treat the implementation of new guidelines as a temporary project instead of a continuous process of change.

The discussion is based on a study from Sweden that used a method called "participatory research." This approach involves researchers working directly with the people who will be affected by the research. In this case, researchers, healthcare workers, and individuals with personal experience of falls worked together to "co-create," or jointly develop, a tool to help healthcare staff use the WFG in different care settings. This collaborative method helps ensure that the tools created are relevant, easy to use, and likely to be used over the long term.

The experience in Sweden shows that having "local champions"—enthusiastic staff members who promote the new guidelines to their colleagues—and supportive leadership is essential. These elements help connect the high-level guidelines with the day-to-day work of frontline health workers.

However, major difficulties remain. These include documentation systems that are disconnected from one another, making it hard to get a complete patient history. Other problems are low levels of skill in using digital tools among staff, and "communication silos," where different departments or teams do not share information effectively. These barriers make it difficult to incorporate fall prevention into routine patient care.

The text concludes with a worldwide call for action. It suggests that the Swedish model of collaborative co-creation can serve as a useful guide for others. It recommends investing in leadership training, ensuring middle management is involved in the process, and developing the necessary digital systems and technology. The goal is to make the World Falls Guidelines a practical achievement in clinical care and public health, rather than just an idea on paper.