A Healthcare Revolution

Monitoring is in the midst of a technological revolution

• By Paul Baratta
• Jun 01, 2019

In 2017, the state of California passed Senate Bill 1299, ushering into law a set of regulations requiring California healthcare providers to take specific steps to prevent workplace violence and ensure a safe environment for both patients and caregivers. The standard, championed by National Nurses United as a “model for the nation,” covers a wide range of preventative measures, including the development of comprehensive risk assessment plans, creation of procedures to mitigate perceived risks, establishment of a response plan for violent incidents, and more. When passed, the law was hailed as a major landmark for workplace safety in the healthcare industry.

Last year, Congressman Ro Khanna introduced H.R. 5223, a bill that would follow the example set by California on a national scale, offering healthcare providers throughout the country a similar level of protection. While the law has yet to pass, nursing organizations throughout the country continue to advocate on its behalf, viewing the bill as an ideal opportunity to curb incidents of workplace violence throughout the country while simultaneously increasing the quality of patient care.

Why the sudden focus on violence in healthcare? The California law was only recently passed, and it didn’t take long for Congress to take up the fight on a national level. Is healthcare safety in crisis? Have we reached a tipping point?

Perhaps we have. The truth is that technological advancements in security and patient monitoring have given us the tools we need to address the issue of violence in new and innovative ways. Understanding the dangers faced by those in the healthcare industry is critical, and exploring the solutions available is essential.

Stemming the Rising Tide of Healthcare Violence

The 24-hour news cycle spends an alarming amount of time filling our homes (and our heads) with visions of tragedy and violence, but the truth is that violent crime is actually decreasing throughout the United States. In fact, Pew Research notes that violent crime has been nearly cut in half in the past three decades alone—a remarkably positive trend at a time when public perception might lead you to believe precisely the opposite.

Unfortunately, this trend has not extended to the healthcare industry, where violence is actually rising. The Bureau of Labor Statistics reports that healthcare workers in inpatient facilities are five to 12 times more likely to experience nonfatal workplace violence than the average worker. In fact, a 2015 study of hospital employees indicated that 88 percent of respondents had experienced a violent incident in the workplace within the past year that they chose not to report to their employer. Think about that. That doesn’t mean 88 percent experienced a violent incident—it means 88 percent had a violent incident that they chose not to report. The total percentage of employees who have experienced a violent incident is almost certainly even higher.

These facts are extremely disturbing, but the underlying reasons are little mystery to those in the industry. Emergency departments are becoming increasingly overcrowded, placing desperate people in stressful situations. The continuing epidemic of drug usage introduces a further unstable element into emergency services, as unpredictable patients under the influence of narcotics flood already crowded care facilities. In addition, there are simply not enough places to put behavioral patients—drug or otherwise—which often results in patients who need special monitoring and more direct supervision being forced into general patient areas where they pose a significant risk to themselves and those around them.

These workplace violence incidents are serious. Nurses, in particular, are often the victims of hair pulling, unwanted grabbing, biting, and more. And these are just the everyday incidents of violence. One nurse interviewed by Politico recalled a fellow nurse almost being strangled with IV tubing. Another noted the alarming frequency with which hospital staff are threatened with violence—often in very specific and graphic ways, including gun violence and death threats. The problem is a gravely serious one, and begs for a solution.

Using Modern Technology to Create Modern Solutions

While hospital overcrowding is part of a larger issue, the safety and security threats that arise as a result can be substantially mitigated with proper use of today’s technology. Significant improvements in surveillance and monitoring capabilities have provided healthcare facilities with innovative new ways to ensure the safety of both patients and providers.

When I say surveillance, you’re probably imagining old school video surveillance: cameras in every room, closely monitored by an overworked security guard in a room full of screens. While that image might have been accurate a few decades ago, we have made significant strides since then. Yes, cameras are still an important part of healthcare surveillance, but no longer are we forced to rely on our friend in the security office to look at the right screen at the right time.

Today’s high-tech cameras are able to not only capture video, but analyze it. In fact, these cameras often have audio capabilities as well, and are able to run acoustic monitoring, gunshot detection, aggressive behavior detection, glass break detection, and more. They have deep learning capabilities, and monitor not just the level of sound, but the full spectrograph—enabling them to, for instance, automatically filter out background noise in a crowded area. They even enable fencing, alerting caregivers if a patient attempts to leave the room, or enters a certain area of the room. It is almost impossible to overstate the value and importance of these on-edge analytics capabilities when it comes to detecting potential hazards for both patients and healthcare professionals alike.

One of the most obvious safety benefits comes with the monitoring of behavioral patients. These high-risk patients necessitate individual monitoring, which simply isn’t feasible for many healthcare institutions. Some have even turned to retired nurses or other healthcare professionals to simply sit inside rooms to keep an eye on these patients. This idea, while perhaps effective on an individual basis, is both inefficient and financially implausible as a long-term solution— not to mention hazardous for the individual monitors. The virtual observation capabilities of today’s networked devices enable effective surveillance of patients on a five-to-one basis, cutting the personnel needed to monitor these patients by 80 percent while removing individuals from potentially hazardous situations.

Today’s monitoring devices and the analytics housed within them can do incredible things. They can identify patients in distress and alert caregivers. They can detect aggressive behavior before someone walks into harm’s way. I have personally witnessed them help identify Munchausen cases, child abuse, and more. These modern devices are able to provide for not only the safety of staff and patients, but higher quality of care and patient satisfaction.

Solving Problems While Improving Your Bottom Line

It is relatively easy to demonstrate how modern technology can help address the issue of workplace violence, but it can be quite a bit harder to convince hospital administrators that the solution is a financially viable one. This is a fair point—although monitoring technology is becoming increasingly affordable, it still represents a substantial investment on the part of the healthcare facility. It’s a financial leap that can be difficult to make, particularly at a time when many hospitals and other facilities face a degree of financial hardship.

While the initial investment in monitoring technology may be steep, many facilities see a return on that investment within months, simply by reducing slip, trip, and fall cases. Slip, trip, and fall incidents are among the most expensive a hospital can face. Not only is there the possibility of extensive litigation on the part of the patient, but falls are not reimbursed by insurance. A study conducted by the Centers for Disease Control and Prevention found that total medical costs for falls totaled more than $50 billion in 2015—a massive, nonreimbursable expenditure on highly preventable incidents.

By implementing improved monitoring and analytics, healthcare facilities can significantly reduce the amount of time it takes nurses to respond to patients, making them less likely to attempt to get out of bed and fall. They can also ensure that help arrives quickly for fall cases, often preventing serious injury through fast response. It can even reduce fraudulent slip, trip, and fall cases filed by patients or hospital visitors hoping for a payout from the provider by supplying clear visual evidence of the incident. The positive impact on the financial health of any individual healthcare facility is both clear and substantial.

Moving Toward a Safer Future

The workplace safety issues facing the healthcare industry are well documented and the severity of the problem is clear, but equally clear is the potential for today’s technology to address these challenges and move the industry into the future. The added security provided by today’s access control, audio/video surveillance, and advanced analytics technologies can protect caregivers while also ensuring the highest quality of care for the patient—all while positively impacting the institution’s bottom line. There is little excuse for allowing the issue of healthcare violence to continue unabated, and as the federal government considers following California’s lead with meaningful legislation, there has never been a better time to modernize.

This article originally appeared in the May/June 2019 issue of Security Today.