Long Island Jewish Medical Center (LIJ) has found a novel way to fight medical errors and improve quality in the operating room: remotely monitoring clinicians via video, Jessica Firger reports for Newsweek.
Hospitals often find it challenging to convince clinicians to follow evidence-based protocols, and in some cases compliance rates remain stubbornly low even after interventions.
Since 2013, LIJ has used remote video monitoring in all 24 of its ORs to help keep the care team on track. The system, created by Arrowsight, feeds live video to remote monitoring centers where Arrowsight employees check in on the ORs every two minutes.
Privacy concerns may hamper hospital quality monitoring
Arrowsight uses a checklist to monitor for common errors, such as a failure to follow hygiene protocols. That information is fed into a real-time data feed of performance statistics, which appears in the OR, on staff members' smartphones, and on screens in the main hub of the hospital's surgery department.
Adam Aronson, founder and CEO of Arrowsight, explained that the system tells staff "exactly what's going on in every room all throughout the day."
Effect on safety and efficiency
For privacy reasons, the video is low-resolution and gets deleted after 24 hours. The goal is to obtain the real-time data, which providers and staff use to identify and act on areas for improvement.
During a 16-week pilot program of the monitoring system, hand hygiene adherence in the OR rose from 10 percent to over 80 percent, according to a study published in Clinical Infectious Diseases. In another evaluation, John DiCapua, chair of anesthesia at LIJ, found the video monitoring system increased adherence to safety guidelines from 24 percent to more than 90 percent.
LIJ has also decreased its OR wait times by about 15 percent, according to a study published in BMJ Quality & Safety.
DiCapua said the system is more seamless than in-person quality monitoring and has helped the hospital become more efficient. "The beautiful thing about video in a timely fashion is it allows you to get a set of powerful data that you can then, as leaders, sit down and make judgements on and understand how to improve," he explained.
According to DiCapua, the hospital has since expanded its system to monitor endoscopy, labor and delivery, and the cleaning of equipment in the ED (Firger, Newsweek, 7/10).
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