Video monitor system helps ensure a timeout
The North Shore LIJ Health System in Forest Hills, NY, is expanding a first-of-its-kind video monitoring system used to measure hand-washing compliance at North Shore University Hospital in Manhasset, NY, by introducing cameras in operating rooms at Forest Hills (NY) Hospital. The pilot program provides hospitals with real-time feedback in their ORs and marks the first time in the United States that remote video auditing (RVA) has been used in a surgical setting, according to North Shore LIJ.
RVA ensures that members of the surgical teams take a timeout before they begin a procedure. The cameras also are being used to alert hospital cleaning crew when a surgery is nearing completion and the pre-operation area when a room is ready for the next case, which helps reduce the time it takes to prepare the OR for the next surgery. To reduce the risk of infections, the monitoring system also confirms whether ORs have been cleaned thoroughly and properly, both between cases and overnight.
The system observes every OR once per minute. It evaluates and sends email/text alerts typically within 2-4 minutes of observing a timeout. It does not does not listen to the timeouts, but the hospital leaders do listen into the rooms separately from the system (on a sampled basis), and they provide real-time feedback if the timeout isn't being verbalized correctly.
The program was designed and implemented by North Shore LIJ's anesthesiology provider, North American Partners (NAPA), in partnership with Mount Kisco, NY-based Arrowsight, a developer and third-party provider of RVA services and software.
The program was initiated in March 2013 in eight ORs at North Shore LIJ's Forest Hills Hospital. "The initial focus at Forest Hills has been on monitoring for surgical timeout compliance, and within just one week of receiving real-time performance feedback, our operating room teams achieved nearly perfect scores," said Rita Merceica, RN, the hospital's executive director.
Given the success of the program at Forest Hills, John DiCapua, MD, chair of anesthesiology at North Shore LIJ, said the monitoring system would be installed in June 2013 in more than 20 ORs at another North Shore LIJ hospital. "We are very excited to bring this important innovation to additional surgical suites," DiCapua said. "We believe that third-party RVA can provide our hospitals with strong, sustainable tools to improve patient safety and perioperative efficiencies."
DiCapua said he expects the pilot projects to be completed by the end of this year and plans on submitting an academic study for publication in 2014.
The introduction of video monitoring in ORs follows its ongoing, successful use in the medical and surgical intensive care units at North Shore University Hospital (NSUH) in Manhasset, NY. A 2011 study published in Clinical Infectious Diseases Medical Journal covered the video monitoring in an article titled "Using high-technology to enforce low-technology safety measures: the use of third-party remote video auditing (RVA) and real-time feedback in healthcare." NSUH demonstrated that the use of a third-party RVA system rapidly improved and sustained hand hygiene rates to nearly 90% in less than four weeks. (Editor's note: To access the abstract, go to http://bit.ly/uDzj8w.)