Safeguarding patients, providers and PPE in today’s healthcare environment

Paul Baratta

Innovation in the field of healthcare is nothing new. Over the centuries we’ve seen a rise in new surgical devices, treatment protocols, and medicines to combat disease, physical frailties, and other medical challenges. But there’s another area where innovation is occurring, and that’s in the way clinicians are interacting with their patients. Today, tele-health visits and virtual patient monitoring have become part of the healthcare delivery landscape. In this expanded model of patient care, hospitals are able to work smarter with their available resources, better protect the health and safety of patients and staff, and conserve the use of personal protection equipment (PPE).

Much of this is accomplished by incorporating traditional security technology into typical clinical tasks:

  • Observing the patient bed area and telemetry monitors known as the patient envelope
  • Conferencing with patients and families
  • Expediting medical response times, especially in case of emergencies

Nowadays you often see video cameras mounted in the ceiling of a patients’ room or mobile cameras attached to IV poles and wireless carts to allow physicians to monitor their patients remotely. The video cameras might be embedded with video and audio analytics to detect signs of patient distress and alert staff. Some facilities are integrating their in-room cameras with telemetry devices monitoring a patient’s vital signs. So instead of relying solely on clinical data, clinicians can see the patient’s physiology in real-time, which might reveal early warning signs of a problem.

While there are infinite ways to use security technology to protect the three Ps – patients, providers and PPE – I’d like to share the stories of two in particular: Nemours Children’s Hospital in Orlando, Florida and Martin Luther King, Jr. Community Hospital in south Los Angeles, California.

Nemours Children’s Hospital: Touchless Yet High Touch

Nemours Children’s Hospital has long been a proponent of using technology to improve patient healthcare. When the Orlando hospital opened its doors in 2012 It became one of the first pediatric hospitals to integrate a host of network-based systems that allowed clinicians to continuously monitor patient’s vitals and validate alarms around the clock.

“We implemented remote third-level monitoring through our Clinical Logistics Center,” explains Joe Summanen, Technical Architect for Nemours Children’s Health System. “It’s like Mission Control. But instead of monitoring astronauts, we’re monitoring kids.”

Manned by paramedics, the room contains dozens of displays that enable the team to track critical details for each patient as well as other activity in and around the hospital. The boards, as the displays are called, post information such as:

  • Patient vital statistics: heart rate, oxygen saturation, etc.
  • Patient healthcare medical records: nine health data points collected through EPIC
  • High-risk patient watch: the acuity score of the sickest patients
  • Paramedic assignments: which patients each paramedic is responsible for monitoring during their shift
  • Emergency department traffic: what patients are coming into the hospital
  • Real-time census: what’s going on at other hospitals in the area
  • Operating room activity: OR team assignments and the capacity schedule of the rooms
  • Transport team activity: graphical mapping of where ambulances are and their estimated time of arrival

But as any med student could tell you, watching monitors is not the same as watching patients. To provide an extra level of care—even when no medical staff is in the patient’s room— the paramedics needed to see the physiology of the child, too. So Nemours decided to integrate network cameras into the EPIC patient monitoring system, including a series of protocols for visual observation that would protect the privacy of patients and their families.

“We put a video camera in every patient room so the Logistics Center could visually evaluate how the patient was doing,” says Summanen. “Especially in pediatric patients, a sudden spike in temperature or heart rate might indicate a life-threatening event. Or it could simply mean the patient is getting agitated while he’s playing a video game in bed.”

Since adding video monitoring into the mix there’s been a significant drop in staff racing to non-events. The technology has also helped improve medical response to actual emergencies. For instance, paramedics were able to spot a toddler having a seizure just after the attending nurse had left the room and sent an immediate alert to the nurse and rapid response to intervene and save the child from brain damage.

“We have countless situations where third-level monitoring has helped us achieve positive outcomes for our patients,” says Summanen. “Through strategic use of the technology, we’ve streamlined response protocols and improved the quality of patient care overall.”

When the pandemic sent the world sideways, Nemours was able to pivot with their network  cameras and video management system to create a more touchless way of delivering patient care.

“When you’re dealing with infectious diseases, or a patient with a weak immune system, it’s important to minimize the risk of exposure – both to the patient and the provider,” explains Summanen. “To that end, we’ve introduced mobile apps through our Milestone video management system and Citrix ConnectCare environment that allow physicians to do virtual rounds.”

The apps give clinicians access to the in-room cameras through their smart phones, laptops, or computers. They can digitally zoom into the bedside monitors, look at the child’s skin tone, see how they’re acting. The apps can also interface with mobile cameras wheeled in on wireless carts so they can conference with the patient and their family remotely, minimizing the number of times they physically step into the room.

Virtual rounds have also impacted the use of PPE. “When you gown up and put on an N95 mask, you have to think about the cost,” explains Summanen. “It’s not only the cost of the materials, but also the cost of having less time to spend with the patient.”

Nemours continues to watch the metrics, comparing in-room vs. remote care. How many changes were made in healthcare plans due to remote or tele-visits? How many physical exam elements were being done by technology versus elements that relied on a clinician being in the room? How often were physical rounds interrupted by encounters that diverted care providers from the task at hand?

“We’re constantly weighing the effects of patient isolation, the fatigue that goes along with social distancing, and the constant gowning and re-gowning of PPE,” assures Summanen. “But at the end of the day, we have to ask ourselves what more can we be doing with our technology to provide better care for our patients, their families, and our staff?”

Martin Luther King, Jr. Community Hospital

Martin Luther King, Jr. Community Hospital (MLKCH), a 131-bed community hospital in the challenging socio-economic Willowbrook community of southern Los Angeles is the second busiest emergency department in LA county. Many of its patients suffer from substance abuse, mental health problems, or the physical tolls of being homeless. Adding pandemic patients to the mix just exacerbated the demands on hospital staff and resources.

But the MLKCH already had tools in place to help them cope. The hospital had recently upgraded their security command center, integrating their network video cameras with a more advanced video management system from Genetec, to give their security team real-time visibility into alerts as they happened. Now the goal was to apply that technology to protecting patients and staff from the spread of infectious disease.

“The first thing we did was a vulnerability assessment,” says Mark Reed, Director of Support Services for MLKCH. “We knew we would be setting up mobile medical tents to handle the surge and that would mean having a lot of staff working outside where we had limited camera coverage.”

The hospital addressed the problem by placing multi-sensor network cameras outside the emergency entrance, at the ambulance bay and on top of the building to give security an overall view of the parking lot and staff as the patients were coming in. “Every camera gave us four views and delivered great resolution,” explains Reed.

MLKCH also pushed its security presence out to the tented area to make sure it was maintaining the proper level of security for their staff, patients, and visitors.

The next step was to restrict access to the hospital itself. Given the physical layout of the property, security decided to funnel everyone to a single access point. “We locked down our card readers so you could only enter the hospital through our main lobby where we stationed additional security officers and staff to screen employees, visitors, and vendors,” explains Jonathan Westall, Vice President of Ancillary Services for MLKCH. “We’re following CDC and public health department guidelines to make sure that anyone entering the building is healthy.”

To further limit the spread of infection, the hospital moved to touchless access points. “We started to deploy facial recognition card readers so our staff no longer have to swipe their badges,” states Westall. The reader recognizes their credentials and automatically opens the door.

“The key for us has been our integrated systems,” shares Reed. “Our cameras, analytics, access control technology and video management system work seamlessly with each other, which gives our security team in the command center the immediate situational awareness they need to protect our community’s health and safety.”

Roadmap to future synergy between security technology and healthcare

As Nemours and MLKCH have discovered, there are innovative ways to utilize surveillance technology and equipment beyond traditional security. Improving  thequality of healthcare, enhancing overall safety in and around the  hospital, and mitigating the spread of infection all contribute to higher patient and provider satisfaction. Whether you’ve already implemented virtual patient observation or are now considering it, video and audio technology can act as a force multiplier now and in the future, supporting medical teams asked to do more with fewer resources.

To learn more about how Nemours and Martin Luther King Jr. Community Hospital are improving care, safety, and security, watch the webinar now.