Topic: Patient Safety

How the North Texas VA Improved Patient Safety and Reduced Costs With Virtual Sitters

Passionate and committed, the virtual sitters at the VA North Texas Health Care System, are not just entry-level, front-line health care workers—they are the unsung heroes who, despite being virtual, forge genuine and heartfelt connections with the veterans under their care. Tiffany Villamin, nurse manager, shared a compelling story during her presentation at the 2023 ANCC National Magnet Conference®, underscoring the indispensable role these virtual sitters play in ensuring the success of the hospital’s virtual sitting implementation. When news of an impending ice storm loomed last winter, these compassionate individuals proactively reached out to Villamin, sharing that they had packed sleeping bags in their trunks and were en route to the hospital to support the veterans and the bedside staff for as long as the crisis lasted.

The VA North Texas Health Care System, a large health system with 13 facilities and more than 700 beds, represents a virtual sitting success story. After adopting this technology, the health system reduced inpatient fall rates by nearly 20% and reduced hourly patient sitting costs by nearly 90%.

This hospital is not alone in facing challenges with patient safety and falls due to labor shortages and escalating costs. It is well established that virtual sitting is superior to one-to-one sitting for patient safety and fall prevention. As virtual sitters can monitor up to 12 patients simultaneously, they also significantly reduce costs compared to dedicated staff at each bedside.

Reducing the Persistent Problem of Patient Falls

Several years ago, inpatient falls became a care improvement focus for VA North Texas as they were expending a significant amount of nursing resources on one-to-one sitters while still experiencing high fall rates.

Falls are costly. Patients injured in falls often require additional treatment and prolonged hospital stays. A recent 8-hospital analysis of over 10,000 patients falls cited by JAMA showed that a fall with any injury is associated with a cost increase of $36,776 and doubles the length of stay.

VA North Texas implemented a virtual sitting program with 2-way video and audio capabilities to connect in-room patients to virtual caregivers. At the heart of the program is a centralized monitoring hub featuring 4 virtual safety attendants who can oversee a total of 48 cameras to reduce patient falls.

An important aspect of virtual sitting is assessing patients individually to determine whether virtual sitting will meet their needs. Conditions that are typically well served by virtual sitters include general safety concerns, such as drug or alcohol withdrawal, confusion, agitation, and elopement risk; failure to follow safety instructions, such as leaving the unit without notifying staff; and high fall risk.

Results: Lower Staff Costs, Fewer falls

Since VA North Texas adopted its virtual sitting program, the health system has freed up front-line staff for direct patient care, an important improvement to overall care delivery and staff satisfaction. By decreasing 1:1 sitter usage, the program allows for better staffing and resource utilization for the entire facility, saving an average of 83 full-time equivalents per month–an annual savings of $3.4 million.

The virtual sitting program enables caregivers in the centralized monitoring hub to have eyes on 12 patients at a time, a huge efficiency gain over one-to-one sitting. As a result of the gains, VA North Texas now has costs of $3.05 per virtual sitting hour, as opposed to an average of $26 per hour for one-to-one sitters–a savings of nearly 90%. Costs are inclusive of both the staffing and technology.

Additionally, fall rates have decreased almost 20% throughout the project. They are now at a fall rate of 1.7/1000 patient days, well below national averages of 3-5/1000 patient days. Shortly, VA North Texas plans to expand the program to the Emergency Department and the mental health department to prevent workplace violence and keep suicidal veterans safer.

For health systems, one-to-one sitters represent a costly drain on resources that do little to improve patient safety. With virtual sitting, health systems such as VA North Texas have created better patient outcomes while delivering staff cost savings that can be invested back into direct patient care.

About the Author

Lisbeth Votruba, MSN, RN, is a third-generation nurse with decades of experience working with intelligent virtual care systems, and is the chief clinical officer of AvaSure.

About the outlet

Veterans Health Today is part of the Population Health Learning Network, a digital network for healthcare providers and decision makers focused on key issues in population health management. 

A proven approach to reducing patient falls while driving staffing efficiencies

In a time where staffing shortages are impacting patient safety, virtual sitting continues to be a proven alternative to 1:1 sitters.

It’s no secret that staffing shortages are having a significant impact on patient safety, particularly when it comes to preventing falls.

Hospitals across the nation have experienced dramatic improvements in fall and 1:1 sitter reduction by adopting the TeleSitter® solution. For example, Community Health Systems (CHS) achieved a remarkable 76% decrease in falls. Similarly, the VA North Texas reduced sitting costs by nearly 90%. These success stories are just a few bright lights among AvaSure’s successful customers.

Over the past decade, nursing research has not only established the feasibility and safety of virtual sitting but has also illuminated its superiority in achieving patient safety outcomes when compared to traditional one-to-one sitting. 

Download the latest use case spotlight to take the first step towards patient safety.

Addressing Workforce Challenges and Keeping Patients Safer: How CHS is Deploying Virtual Patient Monitoring

Explore their journey of virtual patient monitoring from evaluation to implementation to outcomes, including a significant reduction in falls, zero patient falls with injuries in 2022, and improved staffing efficiencies.

Challenge: Reducing Patient Falls

CHS, one of the largest provider organizations in the United States, operates across 43 distinct markets in 15 states. Their decade-long commitment to high reliability, safety, and harm reduction aligned perfectly with the need to reduce falls during the pandemic in 2021. Hospitals across the nation have been grappling with staffing shortages, leading to nurse burnout and a rise in adverse patient events. As the personnel issue worsened, many healthcare systems asked: How can hospitals create a care system that reduces the need for 1:1 patient sitters while allowing nurses to focus on critical patient care?

Evaluating Solutions: Evidence and Scalability

In their quest for the right solution, CHS employs a rigorous evaluation process. Their primary criteria encompass two crucial elements: evidence-based effectiveness and scalability. First and foremost, CHS seeks evidence-backed solutions, emphasizing clinical outcomes and operational impacts. This commitment to data-driven decision-making ensures that any chosen solution delivers tangible benefits across both patient care and operational efficiency.

The second key criterion is scalability. Given CHS’s size, the ability to initially implement a solution at a few select hospitals and then scale it elsewhere across the organization is paramount. In this regard, AvaSure’s TeleSitter solution met these criteria for virtual patient monitoring, making it a natural choice to address their needs.

Phase 1 Deployment: Keys to Success

CHS’s journey with the AvaSure TeleSitter solution commenced with a pilot deployment at three hospitals and then scaled to 17. This pivotal phase yielded notable success, attributed to several critical factors:

  • Intentionality: The deployment of virtual patient monitoring was marked by a deliberate and well-thought-out strategy. Every step was carefully considered, from initial planning to execution, ensuring a seamless integration of the TeleSitter solution into their healthcare ecosystem.
  • Metrics that matter: A key driver of success was CHS’s dedication to data-driven decision-making. They recognized the importance of collecting precise and relevant data to assess the impact of the TeleSitter solution accurately. This commitment to meaningful metrics allowed them to track progress, identify areas for improvement, and ultimately optimize patient care outcomes.
  • Leadership and oversight: Strong leadership and dedicated oversight were pivotal throughout the deployment process. Key leaders within CHS played a central role in driving the virtual patient monitoring initiative forward. Their unwavering commitment and guidance ensured that the program remained aligned with the organization’s broader goals and objectives.
  • Buy-in and Teamwork: CHS understood that achieving the desired results required a collaborative effort. Encouraging buy-in and utilization among staff was essential. Through effective communication, collaboration, and trust, the healthcare team worked together to maximize the benefits of the TeleSitter solution. It became a team effort, with everyone playing a crucial role in its success.
  • Strategic Patient Selection: CHS recognized the importance of strategic patient selection in applying the technology where it would be most effective. Careful consideration was given to identifying patients who would benefit most from the TeleSitter solution, further optimizing its impact on patient safety and care quality.

This comprehensive approach to the Phase 1 deployment set the stage for CHS’s journey implementing virtual patient monitoring, paving the way for positive clinical and operational results.

Outcomes: Reduction in Falls and Positive Operational and Financial Impact

Following the completion of the pilot program, CHS embarked on a thorough analysis, which unveiled some significant outcomes.

  • A Meaningful Decrease in Falls: While CHS has worked effectively to reduce falls for years, implementation of the TeleSitter solution led to an even greater reduction in falls, including a 76% reduction in one hospital.
  • Zero Patient Falls with Injuries in 2022: In 2022, CHS reported zero patient falls with injuries at facilities using virtual patient monitoring. This milestone reflects a profound commitment to patient safety.
  • Savings through Injury Avoidance: The solution translated into meaningful savings through the avoidance of costs related to patient injuries. In an environment where litigation looms, AvaSure can help mitigate potential liability claims when it comes to falls with injury.
  • Staffing Efficiencies of 16 to 1: The introduction of virtual sitters had a strong effect on staffing efficiency. With each virtual sitter capable of monitoring up to 16 patients simultaneously, CHS achieved staffing efficiencies of 16 to 1. This efficiency not only optimized staffing allocation but also enabled caregivers in CHS hospitals to work at the top of their licenses and provide more attentive care to a broader patient population.

These outcomes are a testament to CHS’s commitment to excellence, safety, and innovation. AvaSure delivered quantifiable operational benefit and helped reinforce the high standard of patient care and safety across CHS.

Quality and Patient Care lead to Next Steps

Today, CHS is poised to expand virtual patient monitoring services. With 87 devices currently in place, CHS plans to add 78 more across 12 more hospitals by the end of 2023.

CHS’s innovative approach helps ensure that more patients are kept safe, more healthcare professionals are supported, and the future of healthcare is brighter than ever.

Watch the webinar replay to hear firsthand from CHS about how they expanded their virtual patient monitoring program to enhance patient safety and optimize resource utilization.

Today, CHS is poised to expand virtual patient monitoring services. With 87 devices currently in place, CHS plans to add 78 more across 12 more hospitals by the end of 2023.

The Growing Need for Safety Monitoring Young Patients

Hear from nurse leaders at a children’s hospital and an acute-care hospital on how remote safety monitoring has succeeded in reducing adverse events for pediatric and adolescent patients.

Caring for children in the inpatient setting presents unique challenges. Like adults, kids can misuse medication devices, elope from the hospital and sustain injuries from falls, but their needs are different and require additional attention from nurses. More than ever, young patients have behavioral health problems ranging from eating disorders to major depressive episodes, a situation made worse by the pandemic. Providing one-to-one care for this patient cohort is costly, ineffective, and resource intensive.

Hear from nurse leaders at a children’s hospital and an acute-care hospital on how remote safety monitoring has succeeded in reducing adverse events for pediatric and adolescent patients while reducing stress on families and caregivers.

Presenters:

  • Jamie Clendenin, BSN, RN-BC, Supervisor, Nursing Operations, Anne Arundel
  • Melanie Lee, MSN, RN, CPN, Clinical Director, Pediatric Emergency and Inpatient Unit. Anne Arundel
  • Ashleigh Nurski, MSN, RN, ACCNS-P, CPN Clinical Nurse Specialist, Helen DeVos Children’s Hospital
  • Stacey Overholt, MBA, BSN, RN, Director of Clinical Sales, AvaSure

Keeping Pediatric Patients Safe with Virtual Sitting

Learn why virtual sitting is a solution to address the top patient concern for 2023 – the pediatric mental health crisis.

Caring for children in the inpatient setting presents unique challenges for hospitals across the nation. Similar to adults, kids can interfere with medical devices, elope from the hospital, and sustain injuries from falls, but their primary needs tend to differ and nurses caring for these patients need different support. Pediatric patients have always required a different touch, but the situation is being exacerbated by persistent staffing shortages and the concurrent mental health crisis amongst young Americans. Youth patients in need of behavioral health services are being kept in the ED due to a lack of mental health facilities and appropriate staffing. This makes providing safe and effective care to this important patient cohort costly, ineffective and resource intensive.

Advances in technology, like virtual sitting, have proven to support adequate staffing and allow children to be safe and well cared for. Hear how nurse leaders at a children’s hospital and an acute-care hospital are using virtual sitting for pediatric and adolescent patients and have succeeded in reducing adverse events while also reducing stress on families and caregivers. In addition, they will discuss the policies and procedures to consider and how to get buy-in from your team for this specific patient population. 

Learning objectives

  • Policies and procedures needed for video-monitoring pediatric patients.
  • How to get buy-in from your frontline team to use technology for this sensitive patient cohort.
  • Why virtual sitting is a solution to address the top patient concern for 2023 – the pediatric mental health crisis. 

Webinar: Addressing Workforce Challenges and Keeping Patients Safer: How CHS is Deploying Virtual Patient Monitoring

Many hospitals are experiencing staffing shortages, leading to nurse burnout and an increase in adverse events. How can hospitals create a care system that reduces the need for 1:1 patient sitters while enabling nurses to stay focused on other core patient care duties?

In this webinar, you will hear firsthand from CHS about how they expanded their virtual sitting program to enhance patient safety, optimize resource utilization and reduce costs.

Presenters:

  • Lynn Simon, M.D., MBA, President of Healthcare Innovation and Chief Medical Officer, CHS
  • Pam Rudisill, DNP, RN, MSN, NEA-BC, FAAN, Senior Vice President and Chief Nursing Officer, CHS
  • Ted Lomicka, Vice President, Strategic Analytics, CHS
  • Lisbeth Votruba, MSN, RN, Chief Clinical Officer, AvaSure

Submit the form to view the recording!

Read the press release.

AvaSure TeleSitter® Customer Story Featured in August 31 Webinar

BELMONT, Mich., August 8, 2023 — AvaSure, the market leader in acute virtual care and remote safety monitoring, has invited clinical leaders from Community Health Systems (CHS) to discuss how they deployed virtual sitter technology in their affiliated hospitals to help improve patient safety. During the webinar, to be held at 12:30 pm ET on August 31, CHS executives will share insights into their decision to expand virtual sitting.

CHS sought to use the technology to help reduce patient falls. In doing so, CHS affiliates have also been able to leverage the cost efficiencies of having one virtual sitter monitor 12-16 patients, enabling the hospitals to monitor more patients than with bedside sitters alone – keeping a greater number of potentially vulnerable patients safer.

Presenters:

  • Lynn Simon, M.D., MBA, President of Healthcare Innovation and Chief Medical Officer, CHS
  • Pam Rudisill, DNP, RN, MSN, NEA-BC, FAAN, Senior Vice President and Chief Nursing Officer, CHS
  • Lisbeth Votruba, MSN, RN, Chief Clinical Officer, AvaSure

“Large, diverse health systems like CHS are continually challenged to optimize staff utilization while ensuring care quality,” said Votruba. “With staffing issues impacting hospitals nationwide, and with burnout on the rise, provider organizations are turning to innovative yet proven technology to ensure consistent and constant patient monitoring. This webinar will illustrate how hospitals and health systems of all sizes can leverage this technology to not only ensure more ‘ears and eyes’ on patients, but to make the most of their precious human resources.”

“As a large company that has focused on patient safety for years, we were excited to take this step forward with virtual sitting technology,” said Dr. Simon. “In addition to monitoring patients, the TeleSitter solution helps address workforce challenges by reducing the need for 1:1 sitters and enabling nurses to stay focused on other core patient care duties.”

CHS operates healthcare delivery systems in 43 distinct markets across 15 states. The company’s subsidiaries own or lease 77 affiliated hospitals with approximately 13,000 beds and operate more than 1,000 sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.

Currently relied upon in over 1,000 hospitals, the AvaSure TeleSitter® remote patient video monitoring system aims to improve patient safety by preventing falls and injuries, empowering virtual safety attendants to see anywhere in the room.

To learn more about the August 31st webinar and to register to attend, click here.

About AvaSure

AvaSure provides the leading hospital virtual care platform to systems with nursing and staffing shortages that are challenged to significantly reduce labor costs without sacrificing patient health outcomes. Recently recognized by KLAS Research as the leader in reducing the cost of patient care, AvaSure is the pioneer in providing best-in-class, video-based AvaSure TeleSitter® and TeleNurse™ solutions. As a trusted partner of more than 1,000 hospitals, AvaSure combines remote patient monitors, virtual nurses and other providers on a single platform to enhance clinical care without placing any additional burdens on existing staff. To learn more about AvaSure visit www.avasure.com.

About Community Health Systems

Community Health Systems, Inc. is one of the nation’s largest healthcare companies. The Company’s affiliates are leading providers of healthcare services, developing and operating healthcare delivery systems in 43 distinct markets across 15 states. CHS subsidiaries own or lease 77 affiliated hospitals with approximately 13,000 beds and operate more than 1,000 sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. Shares in Community Health Systems, Inc. are traded on the New York Stock Exchange under the symbol “CYH.” The Company’s headquarters are located in Franklin, Tennessee, a suburb south of Nashville. More information about the Company can be found on its website at www.chs.net.

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Media Contacts:

Marcia Rhodes

Amendola Communications

mrhodes@acmarketingpr.com

Tomi Galin

Community Health Systems

tomi_galin@chs.net

Behavioral health needs in hospitals are rising, are you prepared to keep your patients safe? 

Discover how virtual monitoring for low-to-moderate suicide risk patients can help.

The increasing prevalence of mental health conditions demands innovative approaches to ensure patient safety. Traditional methods like costly 1:1 sitters are unsustainable in the face of labor shortages.  

Over 45% of AvaSure’s clients across the country are embracing virtual sitting for low-to-moderate suicide risk patients, and the results speak for themselves. Increased staff satisfaction, decreased 1:1 sitter costs, and better patient outcomes are just a few of the advantages of implementing the TeleSitter solution. 

Download our latest use case spotlight to access valuable evidence and proven strategies for virtual sitting for low-to-moderate suicide risk patients. 

AONL Industry Insights Webinar: Keeping Pediatric Patients Safe with Virtual Sitting

Caring for children in the inpatient setting presents unique challenges for hospitals across the nation. The situation is exacerbated by persistent staffing shortages and the concurrent mental health crisis amongst young Americans. Hear how nurse leaders at a children’s hospital and an acute-care hospital are using virtual sitting for pediatric and adolescent patients and have succeeded in reducing adverse events while also reducing stress on families and caregivers. This AONL Industry Insights webinar is presented by AvaSure.