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
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
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.