How Virtual Monitoring Technology Improves Patient Safety
By Lisbeth Votruba, MSN, RN
As hospitals and health systems grapple with labor shortages and unsustainable losses, it remains essential that they stay focused on improving patient safety.
However, it’s becoming clear that we are not winning the patient safety battle. A recent study in the New England Journal of Medicine (NEJM), published in January 2023, revealed that nearly 24% of patients experienced an adverse event during their hospitalization in 2018. Although there are no multisite studies of this type yet published from the pandemic years, common sense and a 2021 single-site study by LeRose et al. published in Infection Control & Hospital Epidemiology indicate we are continuing to lose ground.
To overcome challenges associated with staffing shortages and improve patient safety, many leading hospitals and health systems have turned to virtual monitoring technology, in which a remote team of care providers supports a hospital’s bedside providers through audio and visual connections in patient rooms. This model of care helps health systems improve clinical safety and quality while liberating their bedside nurses to provide elevated, hands-on patient care.
A deeper look at patient safety issues
In the recent NEJM study, the most frequently experienced type of patient harm event (39%) was related to an adverse drug event. Other major categories of events related to procedures or surgeries (30%), or related to nursing care, such as falls (15%).
Additionally, the report revealed that 28% of harm events were preventable, with such events commonly linked to substandard or inadequate patient care. The greatest concern associated with these events is the human cost, which may lead to the need for long-term care or life-sustaining interventions. These harms also cost Medicare $520 million in extra spending on hospital care—in just a single month.
Separately, the latest annual report from ECRI that lists its top 10 patient safety concerns highlights staffing shortages and healthcare workers’ mental health as the two greatest threats to patient safety today. “Inadequate staffing is jeopardizing patient safety,” the report states. “Due to staffing shortages, many patients are waiting longer for care, even in life-threatening emergencies, or simply being turned away.”
Unfortunately, with more healthcare workers expected to leave the industry, the problem is likely to grow worse before it gets better, according to ECRI.
A real-world example of how virtual monitoring improves patient safety
Virtual monitoring involves using an augmented care environment where a virtual team provides support to the bedside team—offloading documentation burden, providing a second set of eyes on complex patients, and helping to close growing experience and complexity gaps in nursing. Here is a real-world example of how a health system employed a virtual monitoring solution to advance patient safety.
UCHealth is a nonprofit healthcare organization based in Colorado that consists of 12 hospitals across the state. To improve the quality of patient care, UCHealth sought a solution that would help clinicians find patients who were deteriorating in the hospital sooner, allowing them to provide faster rescue and treatment and deliver better outcomes.
UCHealth was looking to establish this “Virtual Deterioration” program because the health system had experienced high levels of variability when attempting to detect deterioration. The health system’s previous approach created a lot of friction and interruption to the bedside staff who were trying to do hands-on tasks with the patient. For example, previously, once deterioration was detected, staff from a remote clinical command center would reach out to bedside caregivers to determine what happened and what to do next, a cumbersome and inefficient process that excessively burdened frontline staff.
To solve the issue, UCHealth adopted a virtual monitoring solution. The technology provides an audio-visual connection between a patient’s bedside and UCHealth’s clinical command center. The solution consists of mobile carts with cameras that can be wheeled throughout the hospital, as well as cameras attached to the ceilings of rooms.
With the camera in the room, physicians and nurses in the command center can see and interact with the patient as well as the care team. The technology has enabled the health system to reduce phone calls and interruptions at the bedside, allowing caregivers to focus more directly on patients rather than interacting with the command center. The Virtual Deterioration program provides support and makes sure care milestones are being met throughout deterioration events.
UCHealth reports that “code blue” events, which refer to medical emergencies in the hospital, have dropped by 25% to 70% depending on location, which indicates that the health system is detecting deteriorations earlier and reducing negative outcomes. Additionally, the health system has seen an increase of rapid response rates to deterioration events, ranging from 26% to 86% depending on location.
Further, the technology has enabled UCHealth to improve patient monitoring during the post-event period, a time during which the patient is fragile, needs a high level of care, and is at risk of further deterioration. Once a deteriorating patient is stabilized, the camera remains in the patient’s room for six hours, enabling clinical staff to monitor vital signs while allowing frontline clinicians to visit other patients. As a result, UCHealth has seen an increase between 39% and 152% for vital signs being ordered.
In the face of staffing shortages that have potential to harm patients, more hospitals are looking to technology to fill the gap. As such, virtual monitoring solutions will grow more widespread as they continue to demonstrate their value in improving patient safety and clinical quality.
Lisbeth Votruba, MSN, RN, is the chief clinical officer of AvaSure.