Monmouth Medical Center Southern Campus

1. Monmouth Medical Center Southern Campus

2. Monmouth Medical Center Southern Campuslocated in Lakewood, New Jersey

4. Fast Facts on AvaSys • Voice redirection: preset prompts, real time RMA voice, multiple languages, gender preference • One camera per patient • Remote Monitoring Aides are trained NBI personnel • Does not record audio or video • Nursing staff determines need/does not require MD orders • Consent covered under the “admission consent for treatment” • Privacy screens available • Nursing staff provides education to patient and family • Does not replace call button • Does not replace purposeful hourly rounding • Does not import or export PHI • STAT alarm available

5. Present State: • Falls data: • 2012: 3.25/patient days (139 falls) • 2013: 2.80/patient days (94 falls) • 2014: 1.65/patient days (29 falls) • 2015: 1.98/patient days (31 falls) • 2016: 2.49/patient days (41 falls) • 2017: 2.03/patient days (29 falls) • 2018: 1.85/patient days ( 32 falls) • 2019 YTD 1.95/patient days (10 falls) • Total cost for watches in 2017: $274,605.00

6. MMCSC started 2018(Nov/Dec) • Increase high risk for falls • High utilization of safety watch • Define cost allocations/legalities/policy and procedure • Create workflow/algorithm for MMCSC • Education of entire facility – nurses, nursing assistants, supervisors, physicians, environmental services, unit clerks, human resources • Robert Wood Johnson Barnabas Health System Newark Beth Israel Medical Center Hub (20), Clara Maas Medical Center (10), Jersey City Medical Center (10), RWJ – Rahway (5) Community Medical Center (15) and Monmouth Medical Center Southern Campus (5)

7. Initiation of AvaSys Video Monitoring

8. Policy • NO need for MD order • Based on Nursing Assessment and Judgement. • Nursing staff driven • Remotely monitored at another hospital • Provides guidelines for communication and change of shift report at bedside with monitor techs. • Patients data faxed to the monitor techs every shift.

9. Process Improvement Strategies • Staff driven- Buy in from all levels • No order needed from MD • Triaging each shift by Nursing Supervisors to maximize usage at all times. • Easily located in Nursing Office

10. Utilization of Avasys

11. Triage of Avasys Monitors Unit leaders and supervisors triage each shift and daily. Criteria assessed, report off to supervisors, use of log reviewed each shift. Reported in Daily Safety Briefing

12. Use of Dashboard

13. Discontinuation of AvaSys Video Monitoring

14. Reasons for monitoring

15. Reasons for discharge

16. Unit utilized

18. Improved Patient and Family Satisfaction • Anecdotal response from patient call back manager- “When I go home I know he is being watched closer” “It’s a second set of eyes

19. Physician Satisfaction • Physicians discuss and encourage use for patients to avoid use of 1:1. • Discuss and presented at the Performance Improvement Committee with all hospital leadership support.

20. Future plans/lessons learned • Purchasing additional monitors • Improve current Data • Resource for the system on monitoring outcomes and process.

21. Thank You!