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.
Providers are under stress. Kaufman Hall reports that through February, the average hospital operating margin had fallen 42.4% in the first two years of the pandemic, to a negative 3.5%. Widespread staff shortages – mainly but not exclusively nurses – and pandemic-related supply chain challenges drove expenses up 32% in the same two years. There are 3% fewer staff on hand, but those who remain cost far more.
Last September, the CDC reported that because of these stresses, adverse events were on the rise. Infections, central-line and catheter-associated, as well as MRSA, increased exponentially. COVID made close observation of patients harder and delayed responses as RNs and techs needed to don PPE before entering the room. This is why more than 400 hospitals took us up on our offer of free software licenses for using AvaSure’s TeleSitter® solution to monitor COVID patients.
Social isolation and other stressors from the pandemic have also led to an explosion of behavioral health problems, including drug overdoses, suicidality, eating disorders and violence against caregivers.
NEW YORK and GRAND RAPIDS, Mich., Feb. 22, 2022 /PRNewswire/ — AvaSure®, the inventor of the TeleSitter® solution and the market leader in patient safety monitoring, and Equum Medical, a leading telehealth-enabled acute care professional clinical services company, today announced a new strategic partnership to help hospitals address the nurse staffing shortage and slow a sharp spike in adverse events in inpatient care.
Announces New Telehealth Services to Improve Patient and Staff Safety
AvaSure, a leading provider of advanced patient safety monitoring systems, today announced a new leadership structure and a line of business and consulting services intended to significantly improve safety and quality in inpatient hospital environments.
To better align AvaSure’s leadership team with its product portfolio, new services, and robust roadmap, the company announced the promotion of three longtime AvaSure team members to new C-suite roles.
Brad Playford remains in the CEO role, but with a greater emphasis on corporate strategy and vision.
Kyle Pett was named president and chief operating officer, and among other duties, will oversee the company’s new effort to offer contracted remote patient monitoring services to hospitals nationwide. The program will offer hospitals a safe and effective alternative to training their own staff or providing costly in-room patient monitoring.
Lisbeth Votruba, MSN, RN, was named chief clinical innovation officer. She will lead the company’s new clinical consulting arm, which will allow hospitals to work with her and her team to better integrate a patient safety monitoring platform that improves patient outcomes and protects hospital staff.
Toby Eadelman was named chief technology officer. One of his key initiatives involves ORNA®, AvaSure’s Online Reporting of Nursing Analytics. The goal is to better leverage predictive analytics and big data to help hospitals measurably improve patient and staff safety.
The leadership changes and focus on new services are a reflection of the company’s significant growth in recent years, and strengthen AvaSure’s position as a critical partner to hospital leaders nationwide.
John O’Leary, author and activist, kicked off the day with a moving and motivational talk about thriving in the face of adversity. After 20 months of COVID-19, O’Leary encouraged attendees that the best of the journey to better healthcare is to come.
Throughout his keynote, O’Leary prompted attendees to remind their colleagues at all levels that their work matters. At an early age, O’Leary was burned on 100% of his body in an accident, and he spent much of his childhood in the hospital. Throughout his time there, his doctors empowered everyone from custodians to nurses to be a part of his journey.
Today, O’Leary is grateful for the opportunity to speak to the public at events like the AvaSure Symposium. He thanked the hardworking frontline workers, administrators and staff for all that they do, and reminded everyone that gratitude can create the largest impact, reduce stress and help find joy.
Lunch Time Knowledge Bites
After the keynote presentation, attendees had the choice of two Lunch Time Knowledge Bites sessions:
Common Challenges & Misconceptions
Working with Organized Labor & Your TeleSitter® Program
This wide range of topics was perfect for any organization that wants to take a deep dive into their AvaSure TeleSitter® solution and equip staff with what they need to thrive.
Common Challenges & Misconceptions provided both new and existing AvaSure users with insights into how to optimize among both monitor staff and program leaders. Presenter Wendy Popma-Breen, BSN, BS, RN, Clinical Implementation Services Manager at AvaSure, said that transparency and the sharing of information needs to be a key consideration for hospitals and healthcare systems. In many situations, monitor staff are not aware of the conditions or history of the patients they are monitoring. In order to keep patients safe, monitor staff need to be equipped with as much information as possible. Processes can help alleviate this strain, as well as robust onboarding and continuous learning for all staff.
After lunch, attendees attended the Keeping Suicidal Patients Safe, Virtually, presented by UC Davis and Benefis Health. Amid the ongoing mental health crisis, healthcare systems are seeing an influx of patients who are struggling with suicidal ideation, especially among adolescents.
Both teams worked closely with AvaSure to implement TeleSitter solutions that can monitor patients and mitigate risk. One of the biggest benefits of the program is the ability for monitor staff to observe patients 24/7, whereas nurses may not see signs of escalation unless they are in the room. In some case uses, the one-on-one option for the TeleSitter provided an opportunity to form a connection with patients who are in crisis, helping them on the road to recovery.
With no end to the crisis in sight, AvaSure continues its commitment to providing tools and resources to help healthcare systems best serve their patients.
Breakout Sessions
The afternoon breakout sessions included:
Tales from the Front: Early Wins Beget Long-term Success
Fostering New Use Cases for Virtual Care
Standing Up to the Surge: Virtual Nurses Help a Health System Manage COVID
In the face of the COVID-19 pandemic, staffing shortages and a deep freeze that wreaked havoc on much of Texas, Memorial Hermann Health System and its implementation of the TeleSitter program are a case study that all telehealth professionals need to hear.
In July 2020, Memorial Hermann went from initial contact with AvaSure to fully operational coverage of COVID-19 patients in 15 days. Today, Memorial Hermann has over 100 cameras across 12 care facilities in the Houston metro area. The program even allows monitor staff to work from home, when necessary. Their IT team put together workstation kits that included everything an employee would need to work from home alongside their on-site colleagues. When much of the area was hit by an ice storm earlier this year, Memorial Hermann was able to scale its program to continue to provide patients with the safety and monitoring that they needed.
The Memorial Hermann team shared many of the lessons that they learned along the way. For them, staff buy-in was essential, and they made sure that nurses knew that the program was not a critique of their work, but instead, a resource designed to support them. Additional key takeaways included the value of communication, identifying areas of concern, creating an escalation process and developing a pipeline for staffing support.
Panel 2 – Case Closed: Remote Video Monitoring Increases Staff Safety
The final panel of the AvaSure Symposium covered workplace violence. Christina Case, MSN, RN-BC, Clinical Nurse Manager at Providence St. Peter Hospital, presented alongside Lisbeth Votruba, MSN, RN, Chief Clinical Innovation Officer at AvaSure. The duo shared peer-reviewed research, ORNA data and anecdotal evidence on workplace violence and how AvaSure solutions can help prevent it. In fact, ORNA data shows that 17,077 abusive events were prevented at 195 hospitals from July 2017 to July 2021.
Once the TeleSitter was implemented at Providence St. Peter, Case and her team found success in the creation of an educational toolkit. These toolkits improved her staff’s feeling of the program, increased reporting and encouraged engagement. When asked if staff safety was more important than patient safety, Votruba and Case shared that while patient safety is extremely important, it cannot come at the cost of staff safety.
AvaSure sends a sincere thank you to all keynote speakers, moderators, panelists and participants who made the fourth annual AvaSure Symposium a success. Registered attendees will receive a link to the recordings for keynotes, panels and sessions next week.
AvaSure’s fourth annual National Symposium has closed its virtual doors following an inspiring and informative Day 2 on October 7th. Once again, the theme of connection and the growing role of telehealth took center stage as keynote speakers, panelists and presenters shared their insights.
Keynote – John O’Leary
John O’Leary, author and activist, kicked off the day with a moving and motivational talk about thriving in the face of adversity. After 20 months of COVID-19, O’Leary encouraged attendees that the best of the journey to better healthcare is to come.
Throughout his keynote, O’Leary prompted attendees to remind their colleagues at all levels that their work matters. At an early age, O’Leary was burned on 100% of his body in an accident, and he spent much of his childhood in the hospital. Throughout his time there, his doctors empowered everyone from custodians to nurses to be a part of his journey.
Today, O’Leary is grateful for the opportunity to speak to the public at events like the AvaSure Symposium. He thanked the hardworking frontline workers, administrators and staff for all that they do, and reminded everyone that gratitude can create the largest impact, reduce stress and help find joy.
Lunch Time Knowledge Bites
After the keynote presentation, attendees had the choice of two Lunch Time Knowledge Bites sessions:
Common Challenges & Misconceptions
Working with Organized Labor & Your TeleSitter® Program
This wide range of topics was perfect for any organization that wants to take a deep dive into their AvaSure TeleSitter® solution and equip staff with what they need to thrive.
Common Challenges & Misconceptions provided both new and existing AvaSure users with insights into how to optimize among both monitor staff and program leaders. Presenter Wendy Popma-Breen, BSN, BS, RN, Clinical Implementation Services Manager at AvaSure, said that transparency and the sharing of information needs to be a key consideration for hospitals and healthcare systems. In many situations, monitor staff are not aware of the conditions or history of the patients they are monitoring. In order to keep patients safe, monitor staff need to be equipped with as much information as possible. Processes can help alleviate this strain, as well as robust onboarding and continuous learning for all staff.
After lunch, attendees attended the Keeping Suicidal Patients Safe, Virtually, presented by UC Davis and Benefis Health. Amid the ongoing mental health crisis, healthcare systems are seeing an influx of patients who are struggling with suicidal ideation, especially among adolescents.
Both teams worked closely with AvaSure to implement TeleSitter solutions that can monitor patients and mitigate risk. One of the biggest benefits of the program is the ability for monitor staff to observe patients 24/7, whereas nurses may not see signs of escalation unless they are in the room. In some case uses, the one-on-one option for the TeleSitter provided an opportunity to form a connection with patients who are in crisis, helping them on the road to recovery.
With no end to the crisis in sight, AvaSure continues its commitment to providing tools and resources to help healthcare systems best serve their patients.
Breakout Sessions
The afternoon breakout sessions included:
Tales from the Front: Early Wins Beget Long-term Success
Fostering New Use Cases for Virtual Care
Standing Up to the Surge: Virtual Nurses Help a Health System Manage COVID
In the face of the COVID-19 pandemic, staffing shortages and a deep freeze that wreaked havoc on much of Texas, Memorial Hermann Health System and its implementation of the TeleSitter program are a case study that all telehealth professionals need to hear.
In July 2020, Memorial Hermann went from initial contact with AvaSure to fully operational coverage of COVID-19 patients in 15 days. Today, Memorial Hermann has over 100 cameras across 12 care facilities in the Houston metro area. The program even allows monitor staff to work from home, when necessary. Their IT team put together workstation kits that included everything an employee would need to work from home alongside their on-site colleagues. When much of the area was hit by an ice storm earlier this year, Memorial Hermann was able to scale its program to continue to provide patients with the safety and monitoring that they needed.
The Memorial Hermann team shared many of the lessons that they learned along the way. For them, staff buy-in was essential, and they made sure that nurses knew that the program was not a critique of their work, but instead, a resource designed to support them. Additional key takeaways included the value of communication, identifying areas of concern, creating an escalation process and developing a pipeline for staffing support.
Panel 2 – Case Closed: Remote Video Monitoring Increases Staff Safety
The final panel of the AvaSure Symposium covered workplace violence. Christina Case, MSN, RN-BC, Clinical Nurse Manager at Providence St. Peter Hospital, presented alongside Lisbeth Votruba, MSN, RN, Chief Clinical Innovation Officer at AvaSure. The duo shared peer-reviewed research, ORNA data and anecdotal evidence on workplace violence and how AvaSure solutions can help prevent it. In fact, ORNA data shows that 17,077 abusive events were prevented at 195 hospitals from July 2017 to July 2021.
Once the TeleSitter was implemented at Providence St. Peter, Case and her team found success in the creation of an educational toolkit. These toolkits improved her staff’s feeling of the program, increased reporting and encouraged engagement. When asked if staff safety was more important than patient safety, Votruba and Case shared that while patient safety is extremely important, it cannot come at the cost of staff safety.
AvaSure sends a sincere thank you to all keynote speakers, moderators, panelists and participants who made the fourth annual AvaSure Symposium a success. Registered attendees will receive a link to the recordings for keynotes, panels and sessions next week.
A recent trip to UCHealth’s Virtual Health Center in Aurora, CO, gave me and a colleague a breathtaking view of AvaSure as an indispensable part of healthcare delivery. From a central observation facility, this multi-hospital system is keeping patients safe at the bedside, validating telemetry alarms and supporting ICU teams in delivering critical care. In the early stages of COVID, its Virtual Health Center collected and disseminated the latest evidence-based treatment options to frontline staff who barely had time to sleep, much less review clinical research.
We at AvaSure have been planning for these new use cases, but to see them in full flight was inspiring for me and my colleague, Crystal Harding. We could see some of the seams in what the system was doing, but it was real, bringing home the potential of AvaSure to support critical care nurses and technicians as they seek to improve quality, make the highest use of staff resources and take some of the feelings of isolation out of isolation care.
We have names for these new services, but what we are doing is essentially extending the same proven technology that for a decade has been preventing bedside disasters such as falls to provide new layers of virtual care.
Here is some of what we saw on our trip:
The Virtual Health Center has three rooms. In one, five monitor techs were each watching a dozen med-surg patients for the “traditional” risks such as falling, eloping and pulling at lines and tubes. Staff were part of a research protocol on patient selection for remote monitoring. The room was mostly quiet while I was there, though I did witness an intervention to stop a traumatic brain injury patient from trying to go to the bathroom without staff help.
The telemetry room was quite a contrast. It was monitoring 500 patients from multiple workstations. Audible alarms were a constant. As I walked through the room, I imagined the staff hearing those alarms in their sleep.
The front room is the Virtual ICU, where three critical care nurses were using our technology, known as Verify, to watch over patients in all of this system’s hospitals. During night shifts, when physicians at the hospitals may not be as readily accessible, an intensivist physician joins the expert nurses in monitoring care. Verify uses AvaSure’s technology, but instead of a dozen patient rooms on screen, there are 38. Using a variety of physiologic monitors, the team can respond to the most at-risk patients based on bedside nurses’ concern or electronic trigger tools such as sepsis alerts and early warning scores, as well as visually rounding on the ICU patients.
Sepsis is a great example of the success of this approach. The health system has implemented a state-of-the-art sepsis care bundle. Changes in lactic acid levels, blood pressure and heart rate trigger an intervention, as sepsis treatment is so time sensitive. I was told of a novice nurse in one of the system’s smaller facilities who was not administering antibiotics in a timely manner to a patient in danger of slipping into septic shock. The patient had pulled out the IV and the new nurse had not been able to re-insert it. The virtual nurse found the resource needed to get the IV back in and antibiotics delivered quickly.
One of the nurses told me a story of how she witnessed a patient being coded for full cardiac arrest. She noticed that no one in the room was recording the medications given, so she took on the role of virtual recorder. There is an Advanced Cardiac Life Support algorithm that should be followed during a code. She was able to help make sure the team stayed on track. She told me: “I called into the room and reminded everyone, ‘It’s been two minutes since we last gave epinephrine; let’s give another dose now.’”
My colleague and I left our visit so inspired by the work this UCHealth is doing to keep patients safe. When the nurse told me this story, I had a lightbulb moment. While our TeleSitter® application helps keep patients physically safe, Verify is a wonderful tool for clinical safety.
All of this reminded me of a conference presentation I attended pre-COVID about virtual ICUs and the need for faster responses to “triggers,” or changes in physiologic conditions that are most closely tied to the danger of a life-threatening event. The presenters discussed how a bedside nurse has to open the electronic health record to receive one of these triggers, which might not happen if the nurse is occupied talking to a patient’s family or changing a dressing. With a virtual care team in place, the trigger generates an instant response.
The broader role we have envisioned for AvaSure is being actualized on the frontlines of care. We developed the tools, but nurses, doctors and monitoring staff are inspiring us by using them to improve the quality as well as the safety of care.
To share research results in three recent national studies on the use of the TeleSitter solution, AvaSure recently hosted Telesitting: What’s New and Where it’s Heading, a webinar attended by over 500 chief nursing officers from all 50 states plus Washington, D.C., including VAs from around the country. The webinar was presented by AvaSure’s Chief Innovation Officer Lisbeth Votruba, MSN, RN, and Nurse Consultant Patricia Quigley, PhD.
Their studies on Patient Engaged Video Surveillance (PEVS) based on AvaSure’s Online Reporting Of Nursing Analytics (ORNA), the groundbreaking research is clear:
PEVS is clinically proven to foster significantly safer hospital environments for patients and caregivers In addition to considerable cost savings with the use of PEVS, perhaps the most telling outcome of the studies is the substantial improvement in safety for patients in witnessed events.
Prevent Falls In Falls Prevention, the 12-month study of 71 hospitals and 15,021 patients considered as high risk for fall by nursing staff, shows that with PEVS, falls were reduced to .38 falls/1000 patient days of surveillance.
“This is getting to zero, where falls hardly exist,” Quigley said. The study revealed that hospitals equipped with PEVS saw:
A savings of 453 annualized FTEs typically used for traditional sitting, representing over 943,000 hours
A 92 percent reduction to 38 FTEs to monitor PEVS
Improving nurse safety against violence The second study focused on violence against nursing workforce.
“While industry principles, OSHA guidelines and Joint Commission challenges to reduce sentinel events have been published in the past few years, there hasn’t been much improvement in reducing violence,” said Votruba.
This study included 300 witnessed events, 15,434 patients in 73 hospitals over a 21-month period to learn impact of PEVS on nursing workforce safety. The study found that with PEVS, for every abusive event witnessed, 25 were reported, including usually non-recorded verbal incidents.
And while most of the patients in this study were being monitored for fall prevention, and not violence, Votruba noted that these findings present an opportunity for more research on how to identify which patients might have the tendency to become violent.
Using PEVS for COVID-19 isolation patients The third study, by Quigley, Votruba and Jill Kaminski just released in MedSurg Nursing, focused on PEVS for COVID-19’s acute isolation population, monitoring 1,625 patients in 97 hospitals over a two-month (March-April 2020), and representing 98,918 hours of observation.
Key findings included:
42 witnessed adverse events experienced among 39 patients
29 of the events involved a dislodgement of lines
9 falls (one unassisted)
2 self-harm events
2 physical abuse toward nursing events
while response time was lowered due to the donning of PPE, there were more verbal interactions per day to comfort isolated patients during this surge period
These studies show that real-time surveillance at the point of care is cost-effective, improves safety and is easily adoptable by nurses. Nurses were resourceful in fast-tracking the technology in the early weeks of the COVID-19 pandemic as they were pulling from as many resources as they could at the height of the surge.
Lisbeth also shared highlights from several studies she recommends for further reading as CNOs consider the technology for their hospitals. Those studies are linked below for further reading.
AvaSure is working hard to advocate that PEVS programs be a workplace safety initiative through the American Nursing Association.
MUSKEGON, Mich., March 2, 2021 /PRNewswire/ — AvaSure, a leading provider of virtual patient safety monitoring systems, today announced new features of its Online Reporting of Nursing Analytics (ORNA®) software.
ORNA®, AvaSure’s unique comparative database on safety, quality and the experience of care, provides a real-time dashboard for day-to-day clinical triage; hospital-specific data to investigate adverse events; and the ability to run comparison reports with similar hospitals.
The updated software – available early 2021 – allows for comparisons of performance to be more focused, helping to improve outcomes through its TeleSitter® Solution. TeleSitter, an interactive audio/video solution, allows hospitals and other clinical care environments to monitor inpatients to prevent patient harm, protect staff from violent patients and visitors, and enhance nursing resources.
“ORNA® now enables users to run their own comparisons on utilization and alarm rates, and monitor staff interventions and their effectiveness, as well as bedside staff responsiveness,” said Lisbeth Votruba, MSN, RN, chief clinical innovation officer of AvaSure. “Users can compare data with similar organizations nationally or regionally, by market type and filtered by care units or specific groups. This allows the user to educate, evaluate and optimize performance of their TeleSitting program – to see how they stack up relative to similar hospitals.”
As the COVID-19 pandemic continues to rage across the country, it is vital that we continue to shine a light on the threats faced by nurses and other frontline health care workers. In fact, more than 1,700 health care workers have died from COVID-19, according to a September 2020 report by National Nurses United. With gaps in tracking and recording, that number may be much higher.
Every day, hospital staff around the country are putting their health and safety on the line to care for sick patients – and it’s having a toll. Medical personnel account for as many as 20% of known coronavirus cases in some states, according to Kaiser Health News. What health care leaders and society as a whole learn in this moment – about how to care for the nurses and frontline workers who care for us – will prove crucial now and in the future.
