A health system based in Florida has found using cameras can improve compliance with quality and safety efforts, especially when the camera includes a speaker for communicating with people.

Cameras already were in use for security purposes at Lee Health’s facilities, but leaders recently decided to start using a type of camera that includes a speaker, according to Sean Owens, director of security technology and non-acute care. In one use, the cameras are employed as “sitter cams.”

Previously, the health system paid a retired nurse to sit at a patient’s bedside when the patient need to be watched constantly for falls or other risks. The paid sitters were hard to staff because they were needed on short notice — and they were expensive.

Lee Health changed to a system in which the same sitters were stationed in a room with monitors for cameras watching several patients at once. The cameras do not record anything in a patient room, but the observer can summon help immediately to any room. “Not only did we see a reduction in falls, but we were able to expand our monitoring of at-risk patients,” Owens reports. “Patients who were only borderline fall risks before might not have gotten a sitter because ... they didn’t meet the clinical criteria for requiring one.”

Beyond preventing falls, Lee Health uses cameras to monitor a particular stairwell that staff, patients, and visitors used for convenience despite multiple efforts by the hospital to stop the habit. The high volume of traffic in the stairwell was thought to be a safety hazard, with a high risk of trips and falls. Administrators declared the stairway off limits, even though no one could lock the doors for fire safety reasons.

Previously, leaders tried signage, admonitions from supervisors, and even stationing security officers at the exits to remind people of the policy. None of that worked, so administrators installed a camera with a speaker, triggered by motion, in the stairwell. “Imagine you’re in the stairwell and you hear a recorded announcement that this is an emergency exit only. The message even guides you to the proper exit — nothing authoritative or scolding,” Owens explains. “Within the first week of implementing it, that message was enough to change their behavior instantly. We had complete compliance moving forward.”

The camera system also can help with infant abductions, Owens notes. The National Center for Missing and Exploited Children, which tracks infant abductions, indicates that people looking to abduct an infant usually will hang out around obstetrical units for some time, watching staff and patients as they wait for the right opportunity.1

“We debuted a camera that uses video motion analytics for loitering. Anyone who spends an extended amount of time in an area will trigger a notification to our security operations center so we can make contact with that person and ensure everything is all right,” Owens says. “We’re able to home in on the human behavior that really matters to us.”

Similarly, Lee Health was able to address a problem with transients and drug abuse in a hospital parking lot. An exterior camera uses motion video analytics in the area to detect anyone loitering on the property after hours, triggering a recorded message telling them they are being watched and to leave. “There has been a complete turnaround in that location. We have had almost complete compliance just by using the audio,” Owens says.

Other than patient safety, hospitals also can use cameras to monitor compliance with handwashing and other infection control policies.2 Here, the camera typically is oriented to capture only the handwashing sink or other work station, with no coverage of patients so as to protect their privacy. Most hospitals using this approach have recorded the video to be reviewed later for compliance, sending feedback and metrics as soon as possible.

In one study, a door sensor triggered the camera to start recording a handwashing station, and the video was sent to a third-party vendor who assessed compliance and sent feedback to the unit.2


  1. National Center for Missing and Exploited Children. For healthcare professionals: Guidelines on prevention of and response to infant abductions, 10th edition; 2014. Available at: http://bit.ly/2m4NjIS. Accessed Sept. 11, 2019.
  2. Armellino D, Hussain E, Schilling ME. Using high-technology to enforce low-technology safety measures: The use of third-party remote video auditing and real-time feedback in healthcare. Clin Infect Dis 2012;54:1-7.


  • Sean Owens, Director, Security Technology and Non-Acute Care, Lee Health, Fort Myers, FL. Email: sean.owens@leehealth.org.