Ochsner Reduces Patient Falls by 51% with Telesitters

Remote monitoring with mobile camera units improves patient safety and saves money 

How do you reduce patient falls across all medical-surgical units in 11 hospitals by 51%? Ochsner Health System did it by rolling out a remote telesitter program, enabling trained patient safety assistants to monitor up to 57 patients each shift via mobile cameras rolled into the rooms of at-risk patients.

Telesitter programs at hospitals across the country have reported similar reductions in falls, as well as savings over utilizing bedside sitters. Costs vary by institution, but UC San Diego Health reports saving $2.5 million over two years.

According to the Agency for Healthcare Research and Quality, 700,000 to 1 million patients suffer a fall in a U.S. hospital each year. Some 30% to 50% of these falls result in injury, according to a Sentinel Event Alert published by The Joint Commission on September 28, 2015.

A deeper look into Ochsner's telesitters initiative could be helpful to other health systems seeking ways to improve patient safety and reduce costs. We explore the device behind this solution, as well as other innovative  tech tools in the January/February issue of HealthLeaders magazine.

The Technology
 

Ochsner began using the AvaSys TeleSitter Solution by AvaSure in May 2016. This mobile device, a continuous virtual patient safety and engagement platform, includes a two-way camera and speaker on a rolling unit, similar to an IV pole. Trained telesitters can monitor up to 16 patients simultaneously (Ochsner telesitters monitor 12 patients each), replacing the need—and cost—for most bedside sitters, while also expanding the number of patients that can be monitored.

Telesitters can speak directly to patients or nurses, activate an automated message if a patient tries to get out of bed while the sitter is speaking to a different patient, or sound an alarm to alert nurses on the floor to attend to the patient.

The camera has the ability to tilt, zoom, and pan. While some facilities opt for equipment that is permanently installed in a room or portable, wall-mounted units, the mobile option offers flexibility and convenience to quickly transport technology to beds where it’s most needed.

Among the advantages this technology delivers:

• Reduces the risk of patient falls
   
• Reduces labor costs for bedside sitters
   
• Conserves nursing resources
   
• Prevents patient elopements

Ochsner's Approach
 

Ochsner has a total of 26 patient safety assistants who have been trained as remote telesitters. Five telesitters work 12-hour shifts alongside nurses who monitor the health system's eICU patients. There are 57 camera units available to all med-surg units throughout the 11-hospital system, and the devices have a 95% utilization rate.

Training for patient safety assistants, as well as nurses on the units, was provided by AvaSure and an essential component of the program, says Anita Campbell, director of Ochsner’s critical care telemedicine and telesitter program. "At the heart of all technology," says Campbell, "you have to have your people engaged on both ends of the camera and the right processes in place."

Initially, there was some resistance from nurses on the units who were concerned about having a camera in the room. Now, they "fight" over the cameras, Campbell says, because "they see we are preventing their patients from falling. Falling increases their length of stay and could result in injuries with harm. We're helping reduce that."

The program also enables Ochsner to "cast a broader net," she says, covering a more patients than the system would have been able to monitor via bedside sitters.

Ochsner does not charge patients for the telesitter services and is not reimbursed for it by payers. "It's considered a standard of care," says Campbell. " We don't need a physician order, but they might ask for it. It's available to all (med-surg) patients if your nurse feels like you need it." It is also possible to run a report from the electronic health record to determine whether a patient is at risk or which patients are high priority.

Outcomes
 

Numerous health systems, hospitals, and rehabilitation facilities report a reduction in falls, as well as reduced expenses for bedside sitters because telesitters are able to monitor more patients simultaneously:

• Ochsner Health System reports a 51% reduction in falls on monitored units and a 26% reduction in the overall system fall rate. Based on total patient days, Campbell says that 91% of Ochsner patients are less likely to fall due to the TeleSitter program.
   
• Northwell Health's Northern Westchester Hospital experienced a 54% reduction in falls and a 72% reduction in sitter expenses, as reported in the September 6, 2018, issue of Journal of Nursing Care Quality.
   
• TIRR Memorial Hermann experienced a 60% reduction in bedsitter costs by using telesitters (who could monitor multiple patients simultaneously), as reported in the July 1, 2015, issue of Healthcare Risk Management. The facility also had a corresponding 54% reduction in staff injuries related to the care of brain-injured patients, which the hospital attributes to the ability to remotely interact with patients rather than intervene in person.
   
• By using the device and trained telesitters, UC San Diego Health decreased bedsitter costs by $2.5 million over two years as published in the June/July 2015 issue of Journal of Nursing Administration.
   
• Sunnyview Rehabilitation Hospital experienced a 20% reduction in falls and saved $186,000 in bedsitter costs as reported in the March/April 2018 issue of Rehabilitation Nursing Journal .

Behind the Innovation
 

The solution AvaSys TeleSitter Solution has been deployed in hundreds of U.S. hospitals and was created by CEO Brad W. Playford, who founded AvaSure a decade ago to develop a clinical solution for his video surveillance company.