UCHealth is a nonprofit healthcare organization based in Colorado made up of 12 hospitals across the state. UCHealth had already implemented AvaSure’s TeleSitter® for patient safety and VerifyTM for virtual ICU. Here, they looked at expanding the use of these technologies to create a program they call Virtual Deterioration. Keep reading to learn more about this new case use.
Challenge
Looking to identify deteriorating patients sooner The organization had a new use case for virtual care, a program called Virtual Deterioration. Through this virtual platform, they were looking to identify patients who were deteriorating in the hospital sooner in order to provide rescue and treatment faster, enhancing better overall outcomes.
Solution
AvaSure reduced Code Blues by as much as 70% Early outcomes using AvaSure to watch ICU patients for deterioration have shown significant promise in reducing cardiac arrests by as much as 70%. Additionally, UCHealth has seen an increase in rapid response events (26%-86%), while Code Blue rates are plummeting (down 25%-70%), mostly in high-risk areas. UCHealth is also tracking whether patients remain in their current environment instead of being transferred to a higher level of care after an event.
Up to an 86% increase in rapid response rates
Up to a 152% increase in post–rapid response vitals being ordered and completed
“And so if you are considering any sort of hybrid approach from, for example, a clinical command center or nursing workflows, you want to have a great platform that you feel your staff can use and interact with seamlessly and with ease.”
There’s no telling what type of illness surges hospitals will see this year: Take lessons from Jefferson Health’s nurse-led virtual nursing pilot program here.
A surge in respiratory viruses over the fall and winter months placed immense capacity and resource strain on hospitals. This year, they can’t afford to wait and see what the next respiratory virus reason might bring.
In this session, leaders from Philadelphia-based Jefferson Health will share how a nurse-led approach helped the organization meet staffing demands during this past pediatric surge in respiratory syncytial virus cases. Colleen Mallozzi, RN, senior vice president and chief nursing informatics officer at Jefferson Health, and Laura Gartner, DNP, RN, clinical informatics director at the health system, will share how the team quickly expanded an existing virtual sitting program into a virtual nursing pilot to meet patient care and staffing demands.
Learning points:
The timely implementation of a systemwide virtual nursing pilot
The CNIO’s pivotal role in ensuring the clinical practice leads the technology and not the other way around
Critical steps to structure the program including the right setting, staffing, and outcome measurements
Presenters:
Colleen Mallozzi, MBA RN, SVP, Chief Nursing Informatics Officer, Jefferson Health
Laura Gartner DNP, MS, RN, NEA-BC, Division Director Clinical Informatics, Jefferson Health
Join AvaSure Chief Clinical Officer, Lisbeth Votruba, MSN, RN, for Session 2! In this on-demand webinar, you’ll learn:
How the Clinical Resource TeleNurse focuses on offloading documentation and administrative burden from bedside teams, helping to optimize your labor force and deliver elevated patient care
What’s driving the need for this nursing model, areas of focus and hear best practices from those who’ve already piloted
Early outcomes from those already using this model to help reduce discharge time, increase patient & staff satisfaction and optimize outcomes
AvaSure: Break Out Session: Tales from the Front: Early Wins Beget Long-term Success
When staff sees the advantages of new technology, they are more likely to champion widespread use and new applications. Two hospitals describe how they achieved and communicated success right from the beginning of their program.
In what is always a popular session, some of the most successful monitor staff from across the U.S. will share best practices that enhance patient and staff safety and the patient/family experience of care.
RN Panel: How Monitor Staff Help Improve Nurse Productivity
Nurse leader, Lisa Crochet at Marianjoy Rehabilitation Hospital discusses the impact of remote video monitoring for overworked staff seeking to focus on their core roles as direct caregivers.
Studies have shown a strong correlation between nurses’ acceptance and use of new technologies to improve patient care—yet, there are currently no studies that have addressed nurses’ acceptance of remote visual monitoring
Assessing nurses’ acceptance of remote visual monitoring (RVM) will provide hospital administrators with a better understanding of how best to mitigate the underutilization of this safe and cost-effective intervention.
Solution
RVM Assessment Tool (RVMAT) The RVMAT was designed to assess the perceived:
Usefulness of the technology, defined as the degree to which a person believes that using a particular system will enhance his or her job performance
Ease of use of the technology, defined as the degree to which a person believes that using a particular system will be free from effort
The 25-item RVMAT uses a 5-point Likert scale: Strongly disagree = 1; Disagree = 2; Neither agree nor disagree = 3; Agree = 4; and Strongly agree = 5. A higher rating indicates a greater acceptance of RVM technology.
Putting the RVMAT to the test The RVMAT was tested among nurses recruited from a large health system.
Participants were eligible to enroll in the study if they met the following inclusion criteria:
Registered nurses
Worked on an adult inpatient unit that utilizes RVM technology consistent with a health system–wide protocol
Able to speak and read English
Willing to provide informed consent
Findings
Completed surveys were available from 412 nurses. The overall total scale mean score was 3.73, indicating a high level of endorsement for RVM among this group of nurses.
The item with the lowest mean score was: “I believe that a sitter is safer than RVM.”
The item with the highest mean score was: “Having RVM available for patient monitoring is valuable.”
The results from this study show that the RMVAT is a valid and reliable instrument to measure nurses’ acceptance and use of RVM technology.
Despite the fact that the majority of nurses who took part in this study had more than 5 years of experience and that the study findings may not be generalizable to nurses with fewer than 5 years of nursing experience, the strengths of the study outweigh the limitations.
Key takeaway
Because nurses are one of the largest users of healthcare technology, using a valid and reliable tool like the RVMAT to measure their acceptance and the perceived usefulness of RVM technology is needed to gain an in-depth understanding of the factors that influence their adoption of healthcare technology. Such information can guide nurse leaders to implement strategies that create a supportive practice environment where direct care nurses are empowered to incorporate innovative technologies into nursing care to improve overall patient health outcomes.
Multiple compounding factors result in the increased demand for additional safety monitoring in the inpatient setting
At a large, academic, Magnet-designated medical center in the Pacific Northwest, nursing leadership saw that the need for sitters was rising. Much of this increasing need was being driven by an increase in admissions for inpatient mental health care, requiring additional inpatient monitoring for suicide risk, substance withdrawal, fall risk, eating disorders, elopement, and general safety concerns for both adult and pediatric populations.
Providing 1:1 care for all is costly, ineffective, and resource-intensive—and has a negative effect on staff satisfaction, patient safety, and productivity.
Solution
Continuous video monitoring with AvaSure
Continuous video monitoring (CVM) was identified as a bridge for the nursing staff to enhance safety for patients and as an additional safety intervention when sitter use was not reasonable or feasible. The trick was implementing this program in a way that would enable it to become an accepted part of the healthcare environment.
Adoption of the AvaSure technology was influenced by nurse enculturation and education, leader standard work (standard parameters used by nurse leaders for process improvement), data tracking management, and patient/family feedback.
A multidisciplinary team
Implementation of this program was organized with representatives from across the hospital, including nursing leadership, clinical nursing staff, Clinical Technology Services, Psychiatric Professional Practice Leader, Marketing, Department of Quality Management, Nursing Resource Management, and Nursing Administration.
Ongoing training and education
The monitoring staff received specialized training related to anticipation of at-risk behaviors, system functionality, determination of adverse events, and chain of resolution. Education focused on the clinical nursing staff and consisted of unit in-services, leadership classes, champion classes, case management classes, and transitional care classes for community partners. Clinical nurse champions were integral to the adoption of technology in all settings.
Development of policy, procedures, and patient criteria
Clearly defined inclusion and exclusion criteria for CVM with the input from clinical nurses allowed for clear expectations for clinical staff members. A decisional algorithm was designed to help nurses with clinical decision-making regarding whether to use a sitter or CVM as an intervention.
Leader standard work
Lean management principles are critical to continuous improvement and empower the frontline staff to solve problems, eliminate waste, standardize work, and improve the value of care delivered to patients. Because Lean management focuses on the frontline staff, it provides an opportunity to enculturate new systems and to identify barriers.
With proper implementation, the benefits became clear.
Enhanced nurse safety: With the video monitoring technicians (VMTs) out of harm’s way, they can act quickly to respond to patients who may be escalating and the nursing staff cannot safely advocate for themselves. This keeps both staff and patients safe during high-risk behavioral events
Often, the verbal alerts from VMTs can deter the patient long enough so that clinical staff can safely enter rooms that may have additional precautions, such the need to don personal protective equipment
Cost savings: Conservative estimates showed that CVM saved this hospital $109,511 in the first 3 quarters of use
Reductions in falls: With CVM, the hospital reported an average of 2768 potential “fall events” prevented each month
Patient and family satisfaction:
93% of family members indicated that they received more respite opportunities because of the presence of the camera
93% of patients and families felt that they had an added level of security
80% said that they had more privacy compared with 1:1 sitters
Conclusions
The CVM program at this hospital has provided a bridge for the nursing staff to use technology to enhance patient safety and to provide an additional opportunity for intervention when sitter use is not reasonable or effective. Implementation of CVM reduced costs, improved resource allocation, and enhanced staff and patient family satisfaction.
