This study was conducted to determine the effectiveness of providing individualized patient education with staff training in addition to usual care, in reducing falls in hospital rehabilitation units.A stepped-wedge, cluster randomized design was used across 8 hospital rehabilitation units.Patients with better cognition (Mini-Mental State Examination>23/30) received individualized education from a trained health professional in addition to usual care.Staff received training to enhance uptake of strategies by patients.The primary outcome measure was falls.Falls data were collected by two methods: case note audits and the hospital reporting system.Data were analyzed allowing for correlation of outcomes within units.Rates of falls per 1000 patient days were compared between groups using negative binomial regression.There were 3606 patient admissions (1983 during the control period; 1623 during the intervention period) during the 50 weeks of the trial.Patients (mean age 81.8years) had a median length of stay of 11 days.There were 576 falls (197 injurious falls), among 384 (10.6%) patients.There was a significant reduction in the rate of falls and injurious falls in the intervention group [196 falls, (7.8 falls per 1000 bed days)] compared to the control group [380 falls, (13.8 falls per 1000 bed days)]; [adjusted incident rate ratio (IRR) 0.60, 95% CI (0.42 to 0.84), p=0.003;]; [IRR for injurious falls 0.65, 95%CI (0.48 to 0.88), p= 0.006].In conclusion, individualized patient education provided by a trained educator who also provides training to staff, reduces falls and injurious falls in hospital rehabilitation units when added to existing falls prevention programs.