Remote Video Auditing Webinar - Becker's Hospital Review Remote Vid… · OR surgical safety checklist results ... – 480 minutes saved per week ($96/min) = full payback in 1 month

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©2017 Arrowsight, Inc. www.arrowsight.com

Remote Video Auditing Webinar

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Introduction

15 Years of Remote Video Auditing (RVA) & Business Intelligence Experience Real-time mobile alerts to managers, live feedback of worker performance, daily reports

Strong track record of driving significant safety & productivity improvements in food manufacturing and healthcare – worker safety, patient safety, food safety

RVA Healthcare Services: Reduce risk of SSIs and HAIs Reduce risk of wrong site surgeries and retained foreign objects Improve patient flow in ORs and throughout hospital Reduce scope related infections

Published Healthcare Studies, Editorials, and Abstracts:

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Arrowsight

Multiple Remote Customer Facilities with Cameras & DVR’s and Remote Video Access

3rd Party Cameras &

DVR’s & Machine Data

Customer Corporate Office with Remote Video Access

3: Daily and Weekly Labor Performance Scorecard Reports E-mailed to Line & Plant Managers

4. Weekly Labor Performance Reports E-mailed to Stakeholders

1: RVA Audits & Live Tours Performed by Arrowsight Auditors

NOC* (US & India)

Facility Site Managers

* NOC = Network Operations Center

Arrowsight Proprietary Internet Hosted Database & Web Servers

2: Real Time Feedback Mediums:Live Data Feeds in Facilities, Text/Email Alerts to Front Line Supervisors

Remote Video Auditing (RVA)Business Process Workflow Diagram

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Hand Hygiene Performance in ICUs Audit Application: Hand hygiene compliance in a 17 bed ICU

Feedback Methods: real-time performance metrics posted to digital boards

Results: Hand hygiene rates rose from ~10% to ~90% in four weeks

Results Published in 2011 CID Study & Cited in 2013 JAMA Editorial

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Patient Privacy – PHI & HIPAA: In operating rooms or ICUs low resolution video is used and no faces or

body parts can be seen Malpractice Liability:

All forms of RVA data reporting are implemented as a “quality improvement initiative” and are labeled with the following language which protects the data from being legally discoverable (this language may vary by state): “Confidential-Education Law 6527, Public Health Law 2805-JKLM”

The video is stored for only 24 hours and is secured in a locked cage onsite in the hospital with only a 3rd party security firm having access to the box; the hospital can only view live video and cannot go back to see recorded video

Unions/HR: All the feedback data is in aggregate form and no individual workers are

singled out

Legal ConsiderationsWhen Deploying RVA in Operating Rooms

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Example of Low Resolution Video

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3rd Party Remote Video Auditing (RVA) OR Patient Safety & Peri-op Services Workflow Diagram

• Cameras installed with low resolution to protect patient and staff privacy• Arrowsight samples each OR every 2 minutes from monitoring centers• Real-time OR status info and OR performance feedback are posted to digital scoreboards in wards and

available as an app on smartphones• Real-time email alerts for timeout variance and OR status changes sent to clinical managers, surgeons and

support staff • Daily performance reports sent to managers

3rd Party Remote Video Auditing

Daily summary reports & text alerts

OR Real-Time StatusReal-Time OR Throughput Metrics

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Remote Video Auditing Structured User Interface

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OR Patient Safety Metrics: • Sign-in Compliance• Time-out Compliance• Sign-out Compliance• Terminal Cleaning Compliance

OR Efficiency Metrics: • Patient Exit to Cleaning Stop

o Patient Exit to Cleaning Starto Cleaning Start to Cleaning Stop

• Cleaning Stop to Room Sterile• Room Sterile to Patient in Room

OR Safety & Efficiency Opportunities

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Real-time Status BoardsDisplayed on Plasma Boards & Smart Phones

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Aggregate Real Time Performance DataDisplayed on Plasma Boards & Smart Phones

Page 11

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Text Messaging / Alerts

Text Alert Team ActionRoom Sterile Anesthesia Room Ready

Patient in Room

Surgeon Come to OR

Drape Down Holding Area PreparePatient

Bed in Room Housekeeping Clean Room

X-Ray Needed Radiology X-ray to OR

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OR Sample Data Analytics

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RVA Daily Dashboard

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1st Case Start Roadmap ToolResults: 300 Minutes/Day of Gained Time

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OR Timeout ImprovementsResults: No Wrong Sited Surgeries Since RVA Inception

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BaselinePeriod 2013

InitialFeedback Q1

2014

Q1 2015 Q2 2015 Q3 2015

Mins

LIJ OR Turnover Time ImprovementsResults: 3% Increase in Surgical Case Volumes with Higher CMI

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2015/2016 BMJ Study & Editorial on RVA in ORsResults: 90%+ OR Safety Compliance & 15%-20% Efficiency Gains

2015 Published

Study

2016 Published Editorial

“This is a landmark study…”

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OR Terminal Cleaning Analytics

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OR Terminal Cleaning Results

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“Best Practices” JCR Educational VideoFeaturing Arrowsight’s RVA Services

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Feb 2017 AORN Journal Article

Summary Results of Published StudyOR surgical safety checklist results

• Timeouts: 90% to 98%• Sign-outs: 70% to 94%

OR Efficiencies• Turnover times reduced from 36 minutes to 30 minutes

– 480 minutes saved per week ($96/min) = full payback in 1 monthOR Cleaning

• Case cleaning: 79% to 93%• Terminal cleaning: 67% to 94%

– SSIs reduced by 10% (later revised to 20%)

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Portable Cameras for OR CleaningResults: 20% Reduction in SSIs

EVS worker places portable camera on wall bracket for in-between case cleaning

& terminal cleaning

EVS worker cleans room EVS worker returns portable camera to the supervisor’s office at end of shift and plugs camera into Internet router

Arrowsight audits OR cleaning performance

and sends daily reports to Peri-op,

ID and EVS managers

Portable, Battery Powered, Self-Recording, Low Resolution Cameras

LEGENDSSI = Surgical Site Infection

EVS = Environmental Services

Peri-op = Perioperative

ID = Infectious Disease

OR = Operating Room

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SSI ROI Calculator

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LIJ Medical Center – Fully Wired Hospital

History of RVA at LIJ 2013 OR Services 2014-2015 added ASC, endo, L&D, dirty work room, scope cleaning, surgical

annex 2016 added hallway cameras throughout building 2017 adding ED

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Dual Use Hallway Mega Pixel Camera Solutions:PPE Compliance & Patient Flow

Isolation Rooms: PPE Donning & Doffing

Compliance Metrics & Alerts

RVA of PPE Compliancefor Isolation Rooms

& RVA of Patient Flow Metrics

Real-time alerts, Intra-shift &

Daily Performance

Metrics

Patient Flow: Discharge > Cleaning > Admission

Time Metrics & Delay Alerts

Dual Use Mega-Pixel Hallway Cameras

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Example of Hallway Camera ViewsMegapixel Camera Wide/Close-up

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2015 Abstract Using RVA Reports Low Baseline PPE Compliance in ICU’s

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Hospital Wide & Floor Level Boards PPE Performance in Isolation Rooms

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Floor Level BoardsPatient Flow Performance

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Scope Reprocessing

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RVA ExampleEndoscope Reprocessing – Daily Report

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Regular Endoscope Cleaning – Clinic Setting Manual Reprocessing Performance

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ADD SCOPE AUDIT DETAILS

Regular Scope – Endo Clinic SettingLeak Test Performance Rates

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RVA Service Options

Short term pilot program for hospitals with existing OR cameras to assess unbiased patient safety & efficiency performance

EVS cleaning program for both ORs and/or isolation rooms using portable cameras

Scope reprocessing (cleaning) program

Full patient safety and patient flow efficiency programs for ORs and other clinical areas through hospitals

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Contact Information

Adam AronsonChief Executive OfficerArrowsight, Inc.Phone: [email protected]

Dr. Brian SchurginChief Medical OfficerArrowsight, Inc.Phone: [email protected]

Michael GoldbergExecutive DirectorLIJ Medical CenterNorthwell HealthPhone: [email protected]

Dr. Sheldon NewmanExecutive Vice Chair of AnesthesiaLIJ Medical CenterNorthwell HealthPhone: [email protected]

mailto:[email protected]:[email protected]:[email protected]@arrowsight.commailto:[email protected]@arrowsight.com

Remote Video Auditing �WebinarIntroductionRemote Video Auditing (RVA)�Business Process Workflow DiagramHand Hygiene Performance in ICUs�Slide Number 5Slide Number 6Slide Number 7Slide Number 8Slide Number 9Real-time Status Boards�Displayed on Plasma Boards & Smart Phones�Slide Number 11Text Messaging / AlertsOR Sample Data AnalyticsRVA Daily DashboardSlide Number 15Slide Number 16�Slide Number 18OR Terminal Cleaning AnalyticsSlide Number 20“Best Practices” JCR Educational Video�Featuring Arrowsight’s RVA ServicesFeb 2017 AORN Journal ArticlePortable Cameras for OR Cleaning�Results: 20% Reduction in SSIsSSI ROI CalculatorLIJ Medical Center – Fully Wired Hospital�Slide Number 26Slide Number 27Slide Number 28Hospital Wide & Floor Level Boards �PPE Performance in Isolation RoomsFloor Level Boards�Patient Flow PerformanceSlide Number 31Slide Number 32Slide Number 33Slide Number 34RVA Service OptionsContact Information