the nash group: sitter usage webinar presentation

change innovation & analytics

Sitter usage webinar

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Housekeeping

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Today’s objectives

Quantify sitter usage Real time monitoring of sitter usage Determine when it is best to “hard‐wire” sitters into the budget

Review alternatives to sitters as outlined in this Medscape article http://www.medscape.com/viewarticle/806798_3


Required metrics

Capture all care givers including care givers pulled out of staffing

Track by care giver type or job class code

Calculate the FTEs, hours and cost of sitter consumption

Track patient types


Patient types

The main reason cited for use of sitters is prevention of patient falls

Patients with specific symptoms or conditions ⁻ Confusion, disorientation, or delirium ⁻ Hallucinations, agitation, psychosis⁻ Physical aggression⁻ Suicidal ideation ⁻ Risk for removal of lines, catheters, devices, or equipment

Physician’s and/or family request


Midwest case study


Emory sitter experience

Clinical Staffing Resources Center (CSRC).⁻ Multidisciplinary team to evaluate the issue

Most frequent indications for sitter use were identified Goal was set to reduce sitter use by 50% across the health care

system in 1 fiscal year without significant negative impact on quality. Baseline data obtained and preliminary questions answered. "Why do

we use sitters, what was the cost, and were sitters the most efficient way to use staff?“

Equipment, education, rounding, culture change Goal to reduce sitter use by 50% in 1 fiscal year without negative

impact on quality was achieved

http://www.medscape.com/viewarticle/806798_5


6 months post implementation


Agency sitter costs


Track usage and share with staff

The most difficult challenge associated with this practice change was shifting the mindset of the nursing staff. Ordering a sitter for any patient situation out of the ordinary was no longer an option. Staff were surprised to learn that presence of a sitter did not necessarily translate into a decrease in falls or other quality metrics. Rather, it was the intentional presence of the nursing staff that was pivotal to the successful reduction in sitter use.


Hours detail report


Cost detail report


Alternative sitter options

Move room close to desk Hourly rounding/toileting schedule Identify patients at risk for fall in shift safety huddles

Identify environmental concerns Bed alarms, bedside commode sensors, chair alarms

Activity aprons Nonskid socks and floor mats Arm bands, chart stickers, color coded blanket

the nash group: sitter usage webinar presentation

Healthcare