Because one-to-one sitter staffing isn't effective for high-risk patients, many leading healthcare organizations are turning to centralized audiovisual monitoring models as an alternative.
During a virtual featured session sponsored by AvaSure as part of Becker's Hospital Review 11th Annual Meeting in May, two telemedicine leaders from New Orleans-based Ochsner Health joined AvaSure's Chief Clinical Innovation Officer to discuss how a TeleSitter program in a hub and spoke format can deliver clinical and financial benefits to health systems:
- Jennifer Humbert, MSN, RN, AVP of Telemedicine at Ochsner Health
- Rachelle Longo, BSN, RN, AVP of Telemedicine Strategic Partnership Solutions at Ochsner Health
- Lisbeth Votruba, MSN, RN, Chief Clinical Innovation Officer at AvaSure
Five insights:
1. A TeleSitter program differs from traditional telehealth consults in several ways. Telehealth consults are short, one-to-one, direct-to-consumer encounters that often occur while a patient is at home. With the TeleSitter solution, one employee monitors up to 16 patients continuously. This type of remote safety monitoring usually occurs in inpatient settings. It's ideal for patients at risk for falls or elopement, at low to moderate risk of suicide or likely to harm staff members. A device is installed in patient rooms with a 360-degree pan/tilt/zoom camera, a two-way microphone and speakers. "Remote monitoring technicians really become part of the care team and engage with patients, even though they work from a centralized hub miles away from the patient's room," Ms. Votruba said.
2. Ochsner Health uses a hub-and-spoke business model to support its TeleSitter program. Ochsner has deployed TeleSitting at 17 facilities and has equipped 108 rooms with AvaSure devices to support 24/7 operations. One reason why Ochsner's infrastructure is so successful is that the telemedicine team focuses on the centralized hub aspect of operations, while the telemedicine strategic partnership solutions team focuses on the "spokes" — that is, the facilities receiving the monitoring services.
3. Change management is a critical component of a successful TeleSitting program. Ochsner found that change management is necessary for both the hub and spoke elements. The telemedicine strategic partnership solutions team visits each facility to review their existing practices for fall prevention. The teams work collaboratively to evolve those processes to the TeleSitter model. Another aspect of change management is demonstrating that this technology is a reliable resource. "We have ongoing relationships with our sites and we participate in post-fall huddles," Ms. Humbert said. "We aren't just replacing a warm body with a camera. We're replacing in-room sitters in way that's reliable and that improves outcomes and quality."
4. A TeleSitter program requires new approaches to talent acquisition and development. When organizations launch a remote safety monitoring program, many simply take their existing in-room sitters, place them in a bunker and expect success. In Ochsner's experience, that doesn't always work. The monitoring staff need a critical thinking mindset, the ability to handle a larger patient load and comfort with technology. In response, Ochsner has changed its staffing model and created new job descriptions for digital healthcare technicians.
5. The return on investment and quality improvements associated with a TeleSitter program can be significant. Ochsner Health has seen a 90 percent cost reduction in their sitter use across the system by using AvaSure's TeleSitter solution. "It's been easy to pitch this service to our partner sites because the ROI is so clear," said Ms. Longo. In addition, Ochsner's fall rate is almost nonexistent while using remote safety monitoring compared to the system fall rates. The TeleSitter team now leads post-fall huddles which ensures standard quality practices across the organization.
To learn more about this session, click here.