Our final Symposium day started off with wisdom and a beautifully passionate talk by Lee Woodruff. She instilled inspiration in everyone and showed us how far love and hope can go.
Following Lee’s talk, we hung out with local artist Erick Picardo, who throughout the day had a community painting piece where symposium attendees helped to paint sections of the piece which represented our growing community and coming together.
The last round of breakout sessions were fascinating and included topics on behavioral health, video monitoring in acute care and rehab, and how to effectively use video monitoring and create a stable base for successful implementation.
Susan Dentzer, a leading national expert in healthcare and healthcare policy, closed off the symposium with endless knowledge and insights into staffing retention and how to keep up with the many changes throughout the healthcare field.
We are sad to say goodbye to such an amazing group of people who came together to gain knowledge into video monitoring and learn how they can effectively help to enhance patient and staff safety in their organizations. We are excited to be a part of your organization and can’t wait to see you again next year.
If you want to connect with a member of our team to learn more about our product, how to enhance your utilization, or have a question, send us a message at info@avasure.com.
We enjoyed another beautiful day here in Grand Rapids, Michigan and kicked off the 2nd Annual AvaSure Symposium with an amazing talk by John Quiñones followed by the start of our many hot topic breakout sessions.
Discussions throughout the day centered around innovation to patient safety, cutting costs, the Impact of Video Monitoring, suicidal discussion panel, and a monitor staff panel. Each discussion was packed full of new information, informative questions, and a wealth of new knowledge and connections.
Throughout the day, artist Eric Picardo from Experience Live Art combined the feelings of community, networking, and growth, to complete 2 of his original paintings. Day 3 will consist of an interactive piece that all AvaSure Symposium attendees can participate in completing.
We ended on a special note with Ingrid Cheslek, MPA, RN, who discussed employee engagement and retention in a field known for high turnover and burnout.
After hours, we enjoyed a wonderful evening walk of ArtPrize through downtown Grand Rapids and are excited to kickoff our final Symposium day with Lee Woodruff.
On October 3, 2018 we kicked off the 2nd annual AvaSure Symposium in Grand Rapids, Michigan. Our day started with some very insightful focus groups and deep discussions at our round table sessions. We also held our first ever Advanced Monitor Tech Training where attendees spent 3 hours in training learning how to enhance their skills and ensure patient and staff safety across a variety of situations that could potentially arise. Our trainees left with a certificate of their completion of the course, new knowledge, and a growing network of peers.
The big event of the day though was our opening reception held at the Grand Rapids Public Museum. We celebrated our 10 year anniversary with a splendid array of food, beautiful and historical exhibits, carousel rides, and live art with Eric Picardo, we had a wonderful time networking and welcoming everyone to the city.
We kicked off the night by recognizing our customers hard work and how their organizations are advancing patient and staff safety.
Congratulations to our 2018 AvaPrize winners!
Hub & Spoke: University of Maryland Medical Center
Path to Zero: Cincinnati VA Medical Center
Video Monitoring Staff Superstar: Laura Torres, UC San Diego Health
The Safety Net Award: Providence St. Peter
We are excited to continue the fun on Thursday with Keynote speaker John Quiñones & Ingrid Cheslek. Stay up to date on the latest happenings by following us on Twitter over these next few days.
It is possible to increase patient safety and decrease in-person observer costs when using all available cameras, all the time. The AvaSure clinical team recommends the following tips for achieving 100% utilization:
Socialization Reaching maximum utilization may begin well in advance of the AvaSys go-live date. Building internal awareness among staff and multidisciplinary teams is critical to fostering acceptance of AvaSys. AvaSure can provide “coming soon” posters, an AvaSys awareness video and eLearning modules for your staff. AvaSure’s eLearning modules provide an excellent introduction to the software and the program. Other avenues of building internal awareness include newsletters and introductions in department and staff meetings. Choose clinical champions from each nursing unit who will participate in the development of policy and workflow and assist with education of staff.
Dedicated monitor staff The staff at the monitor station are an integral part of the patient care team. When choosing team members for the monitor tech position, select individuals who are highly focused on patient safety in their daily work, have a patient care background and are comfortable speaking and engaging with patients. Ensure that each monitor tech has sufficient time in the role to maintain skills and an elevated level of comfort navigating the software and communicating with patients. This will lead to increased level of trust from nursing staff.
Leadership support During the program planning and development phase, AvaSure’s team of clinical nurses will guide and support you with best practice resources. In addition to the time spent with the AvaSure team, an internal work-group of nursing leaders is encouraged to meet regularly for policy and workflow development. When leadership is engaged in this process, the success of the AvaSys program is made a priority and goals are clearly communicated. After the go live of the AvaSys program, a highly involved team is needed to support the monitor techs in their new role and encourage utilization of cameras by the nursing staff. Consider using nursing supervisors as AvaSys “gatekeepers” to ensure that policy and workflows are followed closely on every shift. The use of sharepoint knowledge base could also help provide a centralized, searchable and secure knowledge management system that would allow staff to become more self-sufficient.
Communication The staff at the monitor station are considered an integral part of the patient care team. Encourage frequent communication between the nursing staff and monitor techs. RNs who are assigned to patients on AvaSys should call and introduce themselves to the monitor techs at the beginning of each shift and provide an update on each patient. The more information that the RNs provide to the monitor tech, the more the monitor tech can do to help them keep patients safe. The monitor techs are a reliable source of information on patient behavior as they are the only members of the care team with constant visualization of patients.
Culture Including AvaSys in the culture of safety at your facility is the key to 100% utilization. This can be done by following the above tips and best practice recommendations from AvaSure’s Clinical Program Specialists. AvaSure has a wealth of resources developed after working with successful AvaSys programs around the country. Having a clearly defined policy with inclusion criteria is critical to nurses embracing AvaSys as a nursing intervention. AvaSys should be considered another tool in the patient safety toolbox!
Bonus tip Special populations. Many of AvaSure’s customers are expanding their programs and achieving success utilizing AvaSys to keep behavioral health patients and those with specific medical conditions safe. If you are interested in expanding your program to include monitoring of patients with suicidal ideation, please reach out to your Clinical Program Specialist for assistance and resources.
As a nurse leader, including 14 years as chief nursing officer of the U.S. Department of Veterans Affairs and its 80,000 nursing staff members, and as someone who cares deeply about improving patient care, I am very much looking forward to this year’s event. Even though I have been an AvaSure board member for several years, I was amazed by last year’s inaugural symposium. The turnout, the enthusiasm of AvaSys users, the intense interest from those who were thinking about adopting this solution, the quality of the keynote speakers, and the depth and breadth of the breakout sessions were extremely impressive. I don’t often say this about conferences, but it was exciting. I take great pride in my VA tenure as the chief nursing officer of the largest integrated healthcare system in America. I am equally proud to be a small part of the AvaSure team.
Equally striking was how much of the talk at last year’s Symposium was NOT about patient falls and sitter costs. Of course, those are usually topics 1 and 1A when people are first looking into remote patient monitoring, but most organizations that have implemented AvaSys quickly see its potential across a wider range of uses. Suicide ideation, neonatal care, emergency department care, elopement, illegal drug use, traumatic brain injury, staff safety – well, the list goes on and on.
This year we’ll hear current innovations on some of the same themes, but I sense the emphasis is expanding. User-driven changes in the software are making this a data-driven enterprise. The ability to record patient safety events in real time is informing changes in protocols. The clinical evidence for monitoring a broader spectrum of patient populations is becoming clearer. And, for the first time in patient care, we will have a record of near-misses – adverse events that didn’t happen because of the constant vigilance of video monitoring. (For more on that see my fellow board member Pat Quigley’s post).
The official theme of this year’s symposium is celebrating the 10-year anniversary of the AvaSys technology. To me, the real theme is that remote monitoring is fast becoming a standard of care, much as telemetry is in cardiac care. Soon, I believe, the question won’t be, “Do you have video monitoring in your hospital?” Instead, it will be: “What is your comparative analysis with other institutions in how you are keeping patients and staff safe through telemonitoring?”
At this year’s symposium you will also be introduced to the new software that is improving “hub and spoke” systems – centralized monitoring stations for observation of patients in many hospitals or even multiple states. Imagine the cost savings of having one operations center for hospitals in multiple states, a center that might also include other forms of patient monitoring.
Just looking at the breakout sessions for this year’s event, I can see how AvaSys is already transforming the ED, often the source of patient self-harm, elopement, and attacks on staff.
And once again, I am so impressed by the nationally known keynote speakers who have agreed to present at the AvaSure Symposium. They will provide insights into national health policy and make the emotional case for making sure patients are safe and secure in hospital care.
So, unless you have something else you simply can’t miss in early October, come to Grand Rapids, MI, and join me and hundreds of your peers in learning more about the newest standard of care. Cathy Rick, former chief nursing officer of the U.S. Department of Veterans Affairs (2000-2014), is a healthcare consultant and a faculty member for the Executive Fellowship in Innovation Health Leadership program at Arizona State University.
Spurred by more recent value-based payment programs, healthcare organizations are collecting data through clinical data analytics to measure, trend, and benchmark adverse events at the unit, hospital and system level, and comparing them – or being compared publicly (like it or not!) – with national benchmarks.
It’s not perfect, but we are doing MUCH better at recording and categorizing harms done to patients, even as our track record of preventing them is mixed.
The “Safety Net” for reducing patient harm and falls The measure that is not captured is the patient who almost experienced an adverse event, but that event was prevented because of diligent surveillance, immediate action and rapid staff response. This measure, the prevented adverse event – often referred to as a “near miss” – is the true safety net in organizations.
Only AvaSure’s monitoring and program evaluation has added a level of precision to measure this true patient safety net in organizations. The latest generation AvaSure monitoring software allows these near misses to be captured in real time by the monitor tech. ORNA® – AvaSure’s Online Reporting of Nursing Analytics, is the database that enables you to report, analyze and improve your performance.
How it works When a monitor staff observes a patient starting to inch closer to the edge of the bed or views a patient reaching for an item too far away, the monitor staff initiates a call to the nurse, while engaging the patient to let he/she know that a nurse is on the way to assist them. They encourage the patient to stay in bed so as to remain safe.
The monitoring staff enters data into that specific patient’s adverse event reporting system, and documents the fall as an averted situation and notes the interaction.
As a result, the AvaSure data collected enables you to measure:
The number of patients enrolled in surveillance who almost fell.
The number of patients enrolled in surveillance for fall prevention. Those who tried to get up without help and the fall was prevented.
Reporting and data metrics you care about Beyond an overall fall rate, you can collect the following data, trended monthly/quarterly, and annually:
Overall fall incidence for all patients being watched by AvaSure monitor staff.
Overall fall incidence for those enrolled for fall prevention, as well as the rate for those who did not fall.
Number of patients who had a fall prevented because of monitor staff‘s intervention. This is the true safety net – vigilance, action and response!
Monitor staff performance: The number of interventions/interactions with patients that resulted in a prevented adverse event.
Timeliness of emergency response: The number of seconds for staff to arrive at the patient’s bedside following the monitor tech’s activation of the Stat alarm.
All data elements paint the picture of your organization’s safety net. Importantly, data elements 3, 4 and 5 provide you with valid and reliable data that only AvaSure’s ORNA database can deliver. This is a true measure of vigilance and rapidity of response to urgent or emergent patient safety situations.
To capture the true safety net of early detection and timely workforce response with comparative ease and accuracy is very exciting! For each the “early detection of an at-risk situation,” AvaSure’s ORNA database enables data collection of the risk factor that was mitigated/eliminated because of each detection and near immediate staff response (an average response of 13 seconds).
For those using the new software and ORNA, please share with us your experience with measuring prevented adverse events. For those who are not, I have a simple question: What are you waiting for?
Pat Quigley, PhD, ARNP, CRRN, principal of Nurse Consultant, LLC, AvaSure Board Member
As hospitals evaluate ways to improve patient falls, patient outcomes, advance patient safety and address staffing shortages while minimizing costs, they face a pressing concern: How can they provide 24/7 monitoring for high-risk patients without incurring unsustainable labor costs?
Twenty-three healthcare leaders gathered April 13 for a roundtable discussion sponsored by AvaSure at Becker’s Hospital Review’s 9th Annual Meeting, where Terry Olinger, president of the Hospitals and Clinics Acute Care Group at Great Falls, Mont.-based Benefis Health System, shared how the system used the AvaSys® TeleSitter video-observation system to improve patient safety and lower staffing costs.
“The thing I was really skeptical about was, will this make a difference? … but the [system] really does work … it’s amazing when you see it in action,” Mr. Olinger said. Benefis has been using AvaSys for about two years, with funding support from its foundation.
The AvaSys room unit is offered in three options: a mobile cart, a portable wall-mounted unit or a permanent ceiling unit. It lets a single monitor technician keep tabs via video on up to 12 patient rooms from a command center – at Benefis it is in the patient flow center. The monitor tech can use the two-way audio to immediately intervene via two-way audio when a patient is at risk of self-harm, such as a fall. The monitor tech can talk to the patient to verbally redirect them. If the situation is emergent, the tech can activate an alarm and a nurse will know to get there right away. Overall, AvaSys helps improve staffing efficiencies by allowing nursing assistants to stay on the floor instead of watching patients 1:1.
Mr. Olinger outlined how the hospital reduced both staffing costs and patient falls.
When the Joint Commission issues a Sentinel Event Alert, it is taken seriously by accredited organizations, a warning that they need to immediately focus on and devote resources to the problem in question. The alert states that healthcare workers are now four times more likely to be victimized than workers in private industry. This workplace violence results in low staff morale, lawsuits, and higher worker turnover. It is essential that these industries look into ways of reducing this violence, perhaps through the use of automated risk management tools to save time and have planned out solutions, or with regular check-ins with staff.
Whatever the method, violence must stop. All staff needs to feel safe and secure in their work environment, in whatever capacity that is. Not speaking up about violence is understandable, they can be worried in case they are not believed or they just feel like it’s their job and they should ‘put up with it’, but that is not the case. Employees would feel more open to speaking up if they felt like they could talk openly with their managers, team leaders, etc. these figureheads need to have a relationship to colleagues and tell them that their voice matters and that they should always speak up.
Look beyond only hiring security Organizations must begin to look beyond solutions that only increase security and be ready to act when encountering verbal or physical abuse. The AvaSys TeleSitter Solution is a technology that is already positioned to identify and direct interventions in attacks on staff. Now, with recent advancements in software, AvaSys® assists in the tracking, reporting, and analyzing of workplace violence to reduce the incidence of these events.
Join Commissions action items for reducing workplace violence The Joint Commission has provided a list of action items to guide organizations towards transforming their environments into safe and secure places of employment. The AvaSys technology provides a platform that significantly contributes towards the implementation of these action items, as described below.
Reporting workplace violence is the first step in creating preventative measures. The Joint Commission reports that only 30% of nurses report workplace attacks. AvaSys features an adverse event reporting system with customizable alerts so leadership can be immediately notified when the AvaSys monitor tech observes an event, even if the caregiver does not report it. Specifics of who, when, why, and how can be captured through observation and swift documentation. This is then sent directly to leadership so the incident can be immediately addressed, and appropriate resources deployed.
Only through analysis of data from multiple sourcescan we identify hazards, trends, and new strategies for making the healthcare workplace safe. AvaSys allows for on-demand analysis of not only adverse events but also near misses through AvaSure’s ORNA® Program (Online Reporting of Nursing Analytics). Inputs through the AvaSys software will become meaningful predictive metrics that contribute to the development of better risk assessment tools. By training monitor staff on specifics of reportable elements and details needed, ORNA will become a valuable database to aid in determining risk factors, trends, and areas for improvement.
Update work procedures to keep team members secure. By having the means to call for help we can protect staff, eliminate hazards, and implement safer work practices. AvaSys has a proven track record of already preventing hundreds of potential assaults through the summoning of help by AvaSys monitor techs when they observe threatening situations. The AvaSys Stat Alert alarm, when activated, summons available assistance into the room within seconds. By implementing AvaSys monitoring, staff will feel more protected knowing there is a second set of eyes that will summon help quickly in the event violence occurs. Trends gleaned through analysis will allow caregivers to identify and initiate AvaSys monitoring on patients who are assessed to be at risk for potential violence.
Organizations with a live AvaSys program can begin these interventions immediately. If the software currently in use does not have adverse event or near miss reporting available, then you are eligible for an upgrade.
Contact AvaSure for more information and request your demo to learn how you can prevent further workplace violence against nurses.
Stacey Overholt RN, BSN, MBA, Vice President of Clinical Services, AvaSure
In addition to the rigorous training that AvaSys Monitor Tech receives prior to their first day on the job, the thousands of hours they will spend watching patients on the screen amount to an education on the full range of patient behavior. Making the most of that education, however, is dependent on the monitor techs previous clinical experience.
Many AMTs are or were clinical nursing assistants. This is an invaluable skill set for this new role. Let’s look at what this means in real practice: A monitor tech will frequently see patients becoming restless. The monitor tech without clinical experience may view the behavior as “just something this patient does from time to time.”
The monitor tech with a nursing assistant background will be able to go further and identify the cause of the distress. It may signal a need for toileting or something more serious. Maybe the pain medication that the nurse gave 6 hours ago is starting to wear off.
Ability to predict behavior The monitor tech may not be able to immediately diagnose what’s going on with this patient, but they know what questions to ask. They know how to communicate the patient’s needs to the appropriate clinical staff. This is how an adverse event is prevented. Had the monitor tech not spoken with the patient to ascertain why he or she were restless, the patient may have taken matters into her own hands. This could potentially lead to a fall if the patient would then attempt to get out of bed to use the restroom.
Proper communication In addition to the ability to predict behaviors, a basic knowledge of medical terminology can be key to communication with the clinical staff. When the nurse calls to give the monitor tech report, they will be providing a reason or reasons why the patient needs monitoring. They also will provide additional items for the monitor tech to watch over. The clinician may say, “They have a PICC line in the left arm, a foley catheter and a G Tube.” What does that mean to an AMT who has never worked in a hospital and has no clinical experience? After receiving report, the AMT then asks, “What is a PICC line,” “What is a foley” and, “Where and what is a G-Tube?” When this conversation happens between the AMT and the clinician, the trust is immediately damaged. Inherently, the clinician will avoid important details in future reports to the AMTs because they think, “Why bother. They don’t know what I’m talking about.”
Build trust At AvaSure, our customers frequently report scenarios like this. Many times, we hear our customers state that they wished they would have required a CNA background for the monitor tech role. Having the ability to clinically observe, having a good knowledge base of medical terminology, and prior experience in the hospital setting will ultimately set the AMT up for success. This in turn builds strong trust between the clinical staff and the AMT. Both are key to having a strong AvaSys program.
Pam Werra, RN, Director of Clinical Services at AvaSure
Almost daily we read reports of patients needing to be resuscitated from an overdose while in hospital, or dealers being arrested while visiting a detox patient to make a sale. As many AvaSys® clients know, video monitoring often uncovers drug deals or patients attempting to use their IV to self-administer heroin.
In 2015 the journal Drug and Alcohol Review published a study tracking more than 1,000 patients with substance use disorder. Almost half (43.9%) reported using illicit drugs while they were in the hospital. These patients experience higher levels of HIV/AIDS, Hepatitis C, non-fatal overdose and other injection-related infections requiring hospitalization. Although they need medical care, they are at much higher risk for leaving the hospital against medical advice (43.4% did so at least once).
A 2016 case study published in the journal Case Reports in Infectious Diseases describes a puzzling case of sustained bacteremia that didn’t resolve with multiple antibiotic regimes during the patient’s hospitalization. Eventually, hospital staff discovered the patient was self-injecting heroin with an unsterile needle through his central line. This case highlights the importance of close monitoring inside the hospital for patients with active substance use disorders. Usually, this sort of patient would benefit much more from staying in somewhere like the Enterhealth Ranch, where they can get specialist addiction treatment. However, for one reason or another, they have to be in hospital and so are unable to access that sort of treatment. Nevertheless, they shouldn’t be in a position where they are able to self-administer heroin. Ultimately, the goals of rehabilitation should involve using diagnostic tests such as the 10 panel drug test to provide appropriate treatment and safety for these patients.
“Drug usage precautions,” “possible drug usage through IV” or “watch for drug activity” are seen with surprising frequency as reasons for video monitoring. According to ORNA, AvaSure’s video monitoring database, 60% of hospitals have used video monitoring to prevent drug activity within patients’ rooms. Many hospitals are now adding “substance use disorder” to their video monitoring policy’s inclusion criteria. It is therefore suspected that the Best Treatment Approaches For Drug Addiction might incorporate video monitoring technology in the future.
Addressing this complex and growing epidemic requires a multi-pronged approach that includes compassion and appropriate treatment of the underlying issues. Video monitoring is increasingly used to help hospital staff be aware of and prevent potential adverse events in this challenging patient population.
Lisbeth Votruba, MSN, RN, Vice President of Clinical Quality and Innovation at AvaSure
