A consistent, watchful eye
A consistent, watchful eye: Elizabeth Armour-Roth (right), nurse manager of the Neuro Acute Care Unit, trains health care assistant Kara Andrews on video monitoring protocol. All staff members on the unit follow consistent procedures to ensure patient safety.

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Nursing Innovations

07. Use more video cameras and fewer patient sitters.

When we started extolling the virtues of video monitoring, skepticism was understandably high. How could we possibly replace human sitters with impersonal video cameras? If we didn’t have someone in the room, could we really keep patients safe? Would we be able to respond quickly enough? And how would our patients feel about being on camera 24/7?

We answered these concerns in the same manner that we’d answered concerns about other innovative-butcontroversial ideas: We created a pilot program.

The Neuro Acute Care unit volunteered to be our first video monitoring pioneers. “We were hesitant at first,” says Elizabeth Armour-Roth, the unit’s nurse manager. “But we also recognized that it could be a great thing for our unit.” Working with the management engineers on our Performance Excellence Team, we developed a structured methodology for training staff on the new technology and procedures—so everyone felt confident that patients would stay safe.

Increasing close supervision.

As it turns out, video monitoring allowed us to keep patients safer than ever before. With a health care assistant dedicated to watching up to six patients at a time on the monitor, we were able to provide close supervision to patients who wouldn’t have received it otherwise. And with fewer staff members sitting in patient rooms, we were able to better allocate our nursing resources.

Boosting patient safety.

We located our video monitoring station close to our patients’ rooms, so that we could react to any sudden movements or behavior changes in an instant. And even though we’d removed sitters from many of our rooms, something remarkable happened: in our first year of video monitoring on close supervision patients, we had just two falls.

$282,000 in savings

From September 2010 to June 2011 we gradually implemented video monitoring in four units, and were able to increase close supervision cases while dramatically decreasing sitter costs. Savings will continue to grow as a result of our acute care areas using this technology.

Building better perceptions.

“Video monitoring made our patients and their families feel safe,” says Elizabeth. “It promoted a sense of caring. Patients knew we were watching over them, honoring their concerns, and anticipating their needs.” Perceptions among hospital staff have changed, too, as physicians and nurses throughout our health system have learned about the pilot’s success.

Expanding the pilot.

With the success of the pilot on the Neuro Acute Care unit, video monitoring has been adopted by all acute care units throughout the hospital, including our Rehab Unit, which has seen a significant drop in falls since implementing video monitoring.

Rehab Unit Results With an uncomfortably high number of falls, our Rehab Unit was a perfect candidate for video monitoring. Two falls occurred initially while staff oriented to the video program. After quickly changing their processes, falls in the unit decreased dramatically, and falls on video-monitored patients dropped to zero..