Problem: At an urban academic medical center oncology unit, total falls and falls with injury increased from FY23 to FY24, with the total number of falls increasing from 14 to 18 and falls with injury doubling from five to ten, exceeding national benchmarks. Variable adherence to organizational recommended fall prevention elements (FPE) was identified as a primary cause of the problem. Purpose: The purpose of this initiative was to improve quality and patient safety through fall reduction. A quality improvement process known as the Kamishibai Card (K-Card) was implemented to improve adherence to FPE. The initiative was implemented over 15 weeks during the fall of 2024, impacting over 130 high fall risk (HFR) patients (Morse Fall Scale >45) at the project site. Methods: A site team was mobilized to design and plan the intervention and strategies for success. Staff were oriented to the K-Card process at a staff meeting, unit huddles, and with printed infographics. Bi-weekly, the project lead (PL) assembled a unit roster of HFR patients and conducted K-Card bedside rounds on each eligible patient. Rounding included observation of adherence to FPE and correcting gaps. Data elements of adherence, corrections, and fall incidence were collected and recorded by the PL and reported to staff and leadership for reinforcement and discussion. Results: FPE adherence was 75% at project onset and averaged 93% during implementation. There was an 80% reduction in the incidence of falls during the implementation period when compared to the previous time period in FY24. Fall risk signage, arm bands, and break away cable presence were the top three missed opportunities requiring correction. Conclusion: Implementation of the K-Card process favorably impacted adherence to FPE and showed a reduction in falls when compared to the same time frame the prior year, suggesting effectiveness in reducing fall incidence in HFR patients on the project unit.