3-D Monitoring to Eliminate Patient Falls

While you may think patient falls are inevitable at a hospital, health system Mission Health says it could have the ability to get rid of the problem through the use of virtual 3-D monitoring technologies. It’s so bullish about the technology that it intends to incorporate the machine in every area of its new 220-bed Hospital for Advanced Medicine by the time it opens in Spring 2019.

Falls are a complex problem with multiple causes and risk factors. Fall prevention in hospital isn’t easy, however there are lots of things we can do to help lower the risk. Some hospitals may routinely use some or all of strategies to prevent falls. Please note that not all plans are demonstrated to work for all patients in all settings. Doctors ought to choose strategies in consultation with their care teams, considering all clinical and organisational elements.

To prevent falls that cause injuries, hospitals often encourage patients that have not undergone surgery to stay in bed. However, some medical experts say that may be a large mistake. Numerous studies have proven that immobility increases the chances of muscle atrophy, blood clots, bed scores and delirium. For elderly or very sick patients, the threat is much greater: being trapped for a couple of days may cause a permanent functional decline, making it harder for patients to return home. Nevertheless as evaluation of preventable medical errors increased in recent years, many hospitals set a greater priority on preventing drops than boosting mobility.

The system ran a 90-day pilot in 2015 in its neuroscience unit with the new technology and the advice of IT consultants specialised in healthcare, which is intended to prevent falls. During this period, there were zero unassisted drops with patients tracked by the monitoring technology compared with 10 unassisted falls together with the normal treatment patient group.

The tech, Patient Observer from Cerner, utilizes core camera technologies with a Microsoft Kinect detector and Microsoft Surface Pro 4 tablet system which offers 3-D skeletal visualization and thickness sensing within 20 feet. The software enables a monitor technician to define and draw virtual zones, trip wires and other trigger points around a patient in a field of view.

The camera always monitors human motion and generates an alert when the system detects movement in or around the defined virtual zone. Marc Westle, DO, senior vice president of innovation in Mission Health, states that visual and audible alarms are sent to the monitor technician through a live, high-definition streaming video feed across advanced network services and security and cloud computing.

The technology includes bi-directional sound, which allows the monitor technician to socialize with or listen to a patient room. Mission has shown real value with Patient Observer deployed for Falls-risk patients, yet they think that Patient Observer is a technology platform, which will deliver value on additional use cases throughout the health system.

When it came to the pilot, a group of registered nurses in the neuroscience unit used the Morse Falls Scale standards together with their clinical experience to develop an algorithm to identify patients with the maximum risk for a drop in the unit. This identical group developed a clinical consultancy to deploy the Patient Observer technology, depending on the patient evaluation.

Certified nursing assistants were trained in the technology, then were assigned as track technicians for all patients put on Patient Observer. Westle stated that Monitor techs could communicate with the individual to divert risky behavior or handle the individual’s immediate needs. Bedside care team members could be contacted for any essential problems that couldn’t be handled by the monitor techs. The analysis demonstrated that redirection of the individual was highly successful in reducing the possibility of a fall. These extraordinary results were achieved through participation of clinical resources and integration of technologies to nurse-driven clinical workflows.

Patient Observer is meant to be used as an addition to rather than replacement of a multi-component fall prevention training program. At Mission Health, there’s a comprehensive fall prevention program in place and adhered to by maintenance teams. Standard fall-prevention interventions include: bed locked in low position with rails up, call bell, call light, assistive devices, on-slip patient footwear, dry floor and sufficient lighting, clutter-free space, personal items inside the patient’s reach, proper use of sensory aids, hourly clinician rounds, and patient and family education.

To tailor interventions to each patient, Mission Health also uses the patient’s individual fall risk such as yellow identification armbands or gowns, bed and chair alarms, and alert signage outside the individual’s room. Mission Health is actively engaged in a job expansion that will deploy a total of 84 wireless cameras throughout the health system. To achieve this aim, an off-site central monitoring unit was constructed and is expected to be ready for occupancy in late October. A team of over 12 technicians per change will occupy the central monitoring unit and be cross-trained to give coverage on Patient Observer or telemetry monitoring.