Topic: Sitter Reduction

An Experience Sampling Analysis of the Impact of Video Monitoring Technology and In-Person Sitters on Nurse Burnout

Background:

While it is established that video monitoring technology (compared with the use of in-person sitters) is a safe and cost-effective solution for hospitals, little is known about the impact of these approaches on nurses’ stress and well-being.

Takeaways:

There were positive effects from video monitoring technology and negative effects of in-person sitters on emotional labor and emotional exhaustion, particularly for nurses lower in commitment.

An Experience Sampling Analysis of the Impact of Video Monitoring Technology and In-Person Sitters on Nurse Burnout: The Moderating Effect of Nurse Commitment and Mediating Effect of Emotional Labor
Kluemper, D., (2023). West J Nurs Res. 913-920

Video Monitoring for Fall Prevention in the Hospital: Current Evidence and Considerations

Video Monitoring for Fall Prevention in the Hospital: Current Evidence and Considerations
Ndoda, K., Fechner, J., et al. (2019). J Info Nurs, (4) 30-36

Negative outcomes occur when hospitalized patients suffer a fall. Video monitoring is increasingly used for fall prevention. A literature review was performed on the effectiveness of video monitoring at preventing falls. Considerations are presented for implementation of video monitoring.

The impact of COVID-19 on patient safety attendant use

The Impact of COVID-19 on Patient Safety Attendant Use

Shields, L., Lawson, T., et al. (2021). Nursing 2021, 15(10), 42-28

Patient safety attendants (PSAs) provide constant direct observation to patients who have cognitive impairments or thoughts. Some estimates report that an acute care hospital in the United States may spend more than $1 million annually on PSAs, an expenditure often not reimbursed. With no national defined standards to regulate or monitor PSA use, this study sought to determine the impact of COVID-19 on a PSA reduction program in a large Midwestern healthcare system.

Sierra7, Inc. and Partner AvaSure Awarded the TeleCare Companion Contract for Veterans Integrated Services Network (VISN) 9 VA Medical Centers

Falls Church, VA – 20 June 2023. The Department of Veterans Affairs (VA) has awarded Sierra7 and their partner AvaSure a contract to provide a turnkey TeleCare Companion solution to seven Veterans Health Administration (VHA) Medical Centers within the Veterans Integrated Services Network (VISN) 9 region. VHA is the largest integrated healthcare network in the United States, with 1,506 healthcare facilities, including outpatient sites, that serve 9 million enrolled Veterans each year.

Sierra7 and AvaSure’s TeleCare Companion solution delivers safe, cost-effective observation, communication, and analytics that enhance patient safety and facilitate patient care. At the core of our Telecare Companion approach for the VHA is AvaSure’s TeleSitter® solution, an evidence-based and data-driven approach to connecting caregivers more closely with patients, thereby improving the quality of care. The TeleSitter solution enables patients to be monitored remotely by using mobile video and audio devices. This helps to reduce adverse events such as falls, while freeing up clinical and support staff so they can devote more time to the patient.

Currently used in over 30 VA/Government medical facilities nationwide, VHA attributes the TeleSitter solution with more than a 60% reduction in falls since its deployment in their medical facilities.

“The implementation of advanced telehealth technologies has proven beneficial particularly as it relates to the patient experience, safety, and most importantly increased quality of care for veterans,” said Chief Growth Officer Gina Gallagher. “We are proud that our partnership with AvaSure, one of the leading providers of acute virtual care solutions, will support VHA with the centralization of patient observation and ensuring patient safety at medical centers throughout VISN 9.”

AvaSure’s CEO, Adam McMullin, added, “We salute the VA for their unwavering commitment to supporting our nation’s Veterans. In partnership with Sierra7, our solution will help create a solid foundation for continuous innovation, advancements in patient care and increased staff productivity, satisfaction and retention.”

The VISN 9 award includes the installation of mobile and fixed ceiling hardware devices, performing site assessments, clinical education and training, and ongoing clinical and technical support.

About Sierra7

Sierra7, Inc. is a leading consultant to healthcare and federal agencies nationwide providing IT solutions, consulting services, and citizen engagement support. As a Service-Disabled Veteran- Owned Small Business (SDVOSB) and CMMI-SVC Level 3-appraised member of the government technology and services industry, Sierra7 holds critical federal government prime contracts including T4NG, VHA-IHT, GSA VETS 2, NIH CIO-SP3, NASA SEWP V, VA TeleCare Companion, and several GSA schedules. In 2022, Sierra7 achieved AWS Select Partner status in the Amazon Web Services (AWS) Partner Network (APN), ranked No. 457 on the Inc. 5000 list of the fastest- growing private companies in America, recognized as a Vet100 honoree, and as a Disabled American Veterans (DAV) Midsize Patriot Employer of the Year.

To learn more, visit: https://sierra7.com

Contact: For any media and or public relations inquiries contact, Rachel Thomas, Marketing Manager, at marketing@sierra7.com.

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

Media Contact: Marcia Rhodes, Amendola Communications mrhodes@acmarketingpr.com.

See the full press release here.

We salute the VA for their unwavering commitment to supporting our nation’s Veterans. In partnership with Sierra7, our solution will help create a solid foundation for continuous innovation, advancements in patient care and increased staff productivity, satisfaction and retention.

– Adam McMullin, AvaSure CEO

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.

Sierra7, AvaSure Virtual Monitoring Partnership Recognized as 2023 Disruptive Tech Program Award Recipient from G2Xchange

FALLS CHURCH, Va., April 11, 2023 /PRNewswire/ — Sierra7 and product partner, AvaSure, were recognized as a 2023 Disruptive Tech Awardee for bringing AvaSure’s TeleSitter®/TeleNurse™ solution to Federal healthcare IT programs. This award recognizes an innovative product, program, or emerging technology solution that has been implemented within a Federal Agency and shows measurable results.

“Sierra7 is honored to be recognized alongside our partner AvaSure as a 2023 Disruptive Tech Program Award Winner,” said Rafael Fagundo, Sierra7’s CEO and founder. “I would like to thank G2Xchange for this prestigious award. Our team is proud to continue delivering reliable transformational solutions serving the VA and supporting its mission to enhance the lives of the Veteran community.”

At the height of the COVID-19 pandemic, Veteran Affairs Medical Centers (VAMCs) faced personnel shortages and safety risks for patients and staff. VA’s solution was to implement TeleSitter®/TeleNurse™ enabling medical providers to communicate with patients effectively and safely throughout the pandemic. This solution has made transformational changes by increasing patient safety, improving patient care, and optimizing labor resources at hospitals and medical centers. This technology supports an augmented care environment where a virtual team can assist the bedside team, not replace them.

“We are proud to be such a major part of VA’s drive to improve access to care and quality for the Veterans who have contributed so much to our nation’s security and prosperity over the years,” said Adam McMullin, AvaSure’s CEO. “By establishing new platforms that deliver transformational patient safety and virtual care, we can help VA achieve better health outcomes for Veterans at lower costs.”

Sierra7 and AvaSure continue to develop and drive innovative solutions for VA and the Federal health market. This partnership has resulted in programs that support 29 VAMCs and the award of more than 12 Federal contracts.

G2Xchange will be honoring program awardees, as well as Change Agent Award winners, during their upcoming Disruptive Tech Summit: Programs and Change Agents Shifting the Landscape held in person on Wednesday, April 12, 2023, from 2:00-5:30 PM EDT. Additional event details and registration information can be found here on Eventbrite.

About Sierra7
Sierra7, Inc. is a leading consultant to healthcare and federal clients providing IT, consulting, solutions, and citizen engagement services to federal agencies across the United States. As a Service-Disabled Veteran-Owned Small Business (SDVOSB) and CMMI-SVC Level 3-appraised member of the government technology and services industry, Sierra7 holds critical federal government prime contracts including T4NG, VHA-IHT, GSA VETS 2, NIH CIO-SP3, NASA SEWP V, VA TeleCare Companion, and several GSA schedules. In 2022, Sierra7 achieved AWS Select Partner status in the Amazon Web Services (AWS) Partner Network (APN), ranked No. 457 in the Inc. 5000 list of the fastest-growing private companies in America, recognized as a Vet100 honoree, and as a Disabled American Veterans (DAV) Midsize Patriot Employer of the Year. To learn more, visit: https://sierra7.com.

Contact: For any media and/or public relations inquiries, email Rachel Thomas, Sierra7 Marketing Manager, at marketing@sierra7.com

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.

Media contact: Marcia Rhodes, Amendola Communications, mrhodes@acmarketingpr.com

Read the press release here.

Continuous Video Monitoring: Readiness for Growth

Continuous Video Monitoring: Readiness for Growth
Abbe JR, O’Keeffe C. J Nurs Care Qual. 2022;37(3):225-230.

Challenge

There is a lack of data and metrics available to help determine when a facility is ready to expand its continuous video monitoring (CVM) program. High-level evidence such as systematic reviews indicate that video monitoring can be effective in reducing adverse events and sitter use. Yet it is unclear when and how to demonstrate that a CVM program is ready for expansion.

  • An average of 5593 adverse events were prevented per 1000 patient-days in the past year (such as falls, elopements, and abusive behaviors)
  • When the video monitoring technician sounds the STAT alarm due to concerning patient behaviors, nursing staff had an average response time of 11 seconds to the patient bedside—this is 6 seconds fewer than the average response time according to Online Reporting of Nursing Analytics (ORNA)
  • By replacing up to 13 sitters every shift, this hospital realized a cost savings of $2 million a year—this equates to $200,000 cost savings per camera per year
  • Although this did not include savings related to the prevention of adverse events such as falls, elopements, or line pulls, the costs saved on sitter replacement alone provided for an ample return on investment (ROI)

Solution

CVM readiness for expansion is evident when metrics such as utilization rates, wait-list expansion, and sitter patient population outgrow current camera capacity. 

Utilization rates

Weighing the balance of program cost and associated program expansion needs can be difficult, particularly in cost-containment environments.

One suggestive metric that indicates readiness for expansion of video monitoring programs is climbing and/or high stabilized utilization rates. The initial CVM goal for a large academic Magnet-designated medical center in the Pacific Northwest of the United States was more than 50% of the cameras in use at all times. Within the first year of CVM use, utilization was consistently greater than 80% for all devices, including the 10 mobile units and 3 stationary ceiling mounts located in the medicine unit and pediatric emergency department. This is a total of 13 cameras in use 80% of the time. Mobile devices provide additional flexibility, and the organization’s 10 mobile units are in use 90% to 95% of the time.

With this high utilization rate, and an average length of stay of 64 hours per patient, there is little camera availability despite increased demand from the nursing staff. This leaves only the highest-risk patients on camera, with less room for utilization of CVM for primary fall prevention and overall environmental safety management for less at-risk patients.

Increasing need for sitters

There has been an increase in demand related to patients who require constant observation in all settings. The continued upward trajectory is related to the growth in behavioral health populations—and is a national trend for inpatient pediatrics and adults. In pediatrics, the prevalence of behavioral health admissions has been increasing over time, yet the lengths of stay have been shortened. This results in higher-acuity needs and, thus, more intense monitoring, such as sitter use.

When CVM cannot be implemented because of exclusion criteria, sitter usage is still a necessity. Alternatively, when CVM can be used to replace a sitter, waitlists create a barrier and are yet another indicator that program expansion is needed.

Video monitoring waitlist growth

A waitlist is defined and created by the assurance that all sitters in the system have been trialed on camera and/or excluded because of inclusion criteria constraints.

There is an associated cost with consistent waitlist increases. On average, there is a risk of losing $134,000 annually due to limited availability of cameras. This amount is nearly enough to purchase additional cameras.

Thus, the tracking of CVM waitlist growth can show missed opportunities that provide clear metrics for expansion of CVM programs.

Front-line staff satisfaction

Staff satisfaction is essential to the acceptance of CVM technologies. Thus, frequent and intentional check-ins with staff about their overarching needs and/or readiness for program growth is essential.

A survey implemented at this institution showed that nursing staff were accepting of the technology and most felt it was part of the organization’s culture of safety.

  • 96% of staff were satisfied with or neutral on CVM capabilities related to patient safety
  • 94% were satisfied with or neutral on the decision of the organization to invest in CVM
  • 96% believed investing in additional cameras was operationally necessary

Conclusion

Despite budget challenges and financial constraints, with the right metrics, organizations can clearly show that the benefits of video monitoring outweigh the associated costs, and that ROI can be easily obtained through sitter reduction, prevention of adverse events, and staff satisfaction.