change innovation & analytics
Sitter usage webinar
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Housekeeping
Download today’s PowerPoint presentation from our website www.nashgroup.com
We’ll take questions during the last 10‐15 minutes
We’d like your feedback
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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
© 2016, Confidential and Proprietary
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
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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
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Midwest case study
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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
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6 months post implementation
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Agency sitter costs
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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.
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Hours detail report
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Cost detail report
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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