Centralized Video Monitoring: It's Impact on Patient Safety, Staff Satisfaction and Labor Expense

Purpose:
Purpose of the Centralized Video Monitoring (CVM) program for specified patients was to reduce falls and patient elopement thru real time observation: 1:1 sitter expense, labor expense, and to increase staff safety and satisfaction on 7 acute care nursing units in an integrated safety net hospital.

Significance:
Prior to implementation we experienced 20-30 sitter patients/day with an average of eleven 1:1 sitter rooms/day, paying agencies high dollars to monitor these patients. An increasing concern was how to increase patient and staff safety with potential violent situations.

Strategy and Implementation:
Using the expertise in our organization we contemplated a Black Belt project aimed at reducing sitter use, falls and labor expenses as part of our Lean Quality Model. The mission of this hospital wide interdisciplinary committee was to explore modern day technology in order to enhance the possibility making the environment safer for patients and staff, twenty-four hours per day in the seven acute care units. Discovery: Literature search of camera surveillance technology, telephone conversations and site visit. Examination of costs of equipment with night vision capability, installation and centralized video monitoring technicians (VMTs) Pre-implementation: Worked with information technology (IT) and Legal. Construction of CVM room Install cameras. Develop staff education and patient/family centered education. Implementation: Increase program awareness hospital wide. Develop staff competencies. Develop hospital wide education and standard work. Create electronic documentation.

Evaluation:
The number of sitters decreased to seven 1:1 sitter rooms/day. 1st quarter saving of $392,000, covered cost of equipment and installation. The first year CVM program netted $1.15 million in deferred cost. 57 falls were prevented and 75% of units met or exceeded NDNQI benchmarks for falls.

Implications for Practice:
Staff must be reassured that their practice is not being evaluated. Legal involved prior to and ongoing. Ongoing patient/family centered education. Communication challenges include the criteria for placing the patient on camera and when to remove. Explore other opportunities for improvement.