Remote Monitoring Quietly Keeps Patients Safe

Typically, nursing assistant staff, sitters are assigned to serve as extra eyes and hands for hospitalized patients who have cognitive impairment, delirium, dementia or some other medical condition to prevent them from becoming fall or elopement risks. But sitters, who are assigned to focus on observing patients, cannot do anything else during that time, spiking labor costs for most medical centers. And ironically, although sitters provide extra care for patients in need, they also face the possibilities of physical assault and verbal abuse from some patients they monitor, especially if those patients struggle with cognitive issues and do not understand that they are in a medical setting. 

These days, technology provides a solution to keeping both patients and sitters safe: virtual monitoring, and the VA Maryland Health Care System has embraced this technology, the first health care system in the VA Capital Health Care Network to do so.  At the Baltimore VA Medical Center, a virtual remote monitoring system called CareView has recently been deployed to significantly enhance patient and sitter safety through remote viewing and audio and video feeds.  A grand opening of a dedicated virtual sitter room took place last month at the medical center, and the VA Maryland Health Care System operates a fleet of mobile cameras that can be used anywhere they’re needed. 

“This virtual sitter project was five years in the making,” said Suzanne Hook, chief nurse of operations, who first noticed the virtual sitting system while visiting a friend at a community hospital. “We started exploring acquiring a virtual sitter system before the pandemic, but then -COVID-19 hit, and all our attention became focused on that.”

Once the pandemic’s urgent focus subsided, Hook took up the virtual sitter project with the help of Christina Burgan, the nurse manager who carried the project to completion and who is now overseeing the implementation and operation of the system.   

“We looked at a few systems before we settled on one,” said Hook. 

The virtual sitter system enables technicians to conduct continuous monitoring of multiple patients from one centralized location, and proactively prevents falls while enabling nursing staff to deliver optimal care. Because of audio and visual feeds, the virtual sitter program allows technicians to detect and prevent patient elopement, allowing the nursing staff to intervene in a timely manner to ensure patient safety. Technicians can also monitor patients who demonstrate a low risk of suicidal ideation by adding a level of support and reducing the risk of self-harm. 

Technicians virtually monitoring patients are specifically trained with the skills needed for their particular roles and to interact with patients remotely. Technicians also receive extensive training on what to look for and how to respond to various patient behaviors, especially those that may indicate a safety risk such as confusion or agitation. They also learn to document observations and to maintain patient privacy to adhere to HIPPA regulations. 

“If patients need help or an intervention, the virtual sitter can immediately summon the nursing staff,” said Burgan. “This could be for any number of reasons, such as the patient is experiencing pain or a change in condition or is exhibiting behavior that requires medical attention.” 

The virtual sitter system hub occupies a small room on the fourth floor where computer monitors enable technicians to observe patients needing sitters from computer screens equipped with audio feeds in addition to cameras.

“One technician can monitor 25-30 patients, but we have the capacity to monitor 40 patients using our mobile cameras,” said Burgan, who noted that one mobile camera had been deployed to observe a specific door to prevent and intervene in the event of an elopement. 

Because of the addition of remote sitters, patients at the VA Maryland Health Care System can benefit from the extra eyes and ears focused on them and their safety as they recover.