Oregon Study First to Look at Evidence-Based Expansion of TeleSitter Programs

There is a wealth of peer-reviewed research on AvaSure’s success in helping to reduce falls and sitter costs. Many hospitals that adopt the solution quickly see the financial and clinical payoffs, and look to expand the program. A lot of decisions need to be made, including how many rooms and/or units to cover, the challenges that need addressing, what hardware to employ and whether or not to have a single central monitoring hub or unit-based staff.

A new article in the Journal of Nursing Care Quality, centered on the experiences of Oregon Health & Science University (OHSU), explores the factors that can help clinical leaders make those choices more effectively.

After implementing AvaSure in 2018 with 10 mobile devices and three in-ceiling devices, OHSU was able to stabilize upward trends in sitter use in adult acute care. It quickly became clear that demand at OHSU would outstrip supply. A growing video monitoring waitlist and sitter utilization needs combined with staff shortages to create an urgency to getting certified nursing assistants off of sitter duty and back out on the unit, using AvaSure for every patient who met inclusion criteria.

The authors calculated that continuous virtual monitoring saved $2 million per year just on sitters. An average of 5,593 adverse events were prevented at OHSU per 1,000 patient-days in the past year.

OHSU used a variety of metrics to evaluate AvaSure program expansion, including high video monitoring utilization rates, sitter use demands, wait-list growth and national/local increases in behavioral health needs. “One of our most powerful metrics, however, is the subjective data related to staff perception of need,” the authors write. Acting on the need for expansion from a staff nurse perspective is an “imperative aspect of multilevel empowerment” at OHSU, a Magnet nursing organization.

The team success in writing an expansion initiative using those metrics added 13 mobile devices. A partner community hospital decided to leverage an opportunity to expand AvaSure into its facility for a total of 23 more room devices. As part of the expansion, OHSU is implementing a hub and spoke model with its partner.