LIJ Medical Center Introduces Video Monitoring Project to Enhance Patient Safety in ORs


Once mainly an instrument to protect your belongings and family, cameras have expanded beyond homes and offices into an area where a mistake can mean the difference between life and death: operating rooms. Long Island Jewish (LIJ) Medical Center has installed cameras in all 24 of its operating rooms (ORs), which performed nearly 20,000 surgeries in 2013.

With the national average of approximately 40 wrong-site surgeries and about a dozen retained surgical objects left in patients every week, the new pilot program at LIJ strengthens patient safety by providing hospitals with real-time feedback in their ORs. LIJ and the North Shore-LIJ Health System's Forest Hills Hospital are the only hospitals in the country using remote video auditing (RVA) in a surgical setting, working with Arrowsight Inc.

RVA ensures that surgical teams take a "timeout" before they begin a procedure. The team then goes through a patient safety checklist aimed at avoiding mistakes. Each OR is monitored remotely once every two minutes to determine the live status of the procedure, and ensure that surgical teams identify and evaluate key safety measures designed to prevent "never events," such as wrong-site surgeries and medical items inadvertently left in patients. The cameras also are used to alert hospital cleaning crews when a surgery is nearing completion, which helps to reduce the time it takes to prepare the OR for the next case. To reduce the risk of infections, the monitoring system also confirms whether ORs have been cleaned thoroughly and properly overnight. In a matter of weeks, patient safety measures at both hospitals improved to nearly perfect scores.

"Within weeks of the cameras' introduction into the ORs, the patient safety measures, sign-ins, time-outs, sign-outs, as well as terminal cleanings all improved to nearly 100 percent," says Chantal Weinhold, executive director of LIJ. "A culture of safety and trust is palpable among the surgical team."

Additionally, all staff can see real-time OR status updates and performance feedback metrics on plasma screens throughout the OR and on smart-phone devices.

The program was designed and implemented by North Shore-LIJ's anesthesiology provider, North American Partners (NAPA), in partnership with Mount Kisco, NY-based Arrowsight, Inc., a developer and third-party provider of RVA services and software.

"At a time when healthcare reform plays a significant role in all that we do, it is important to engage the full spectrum of stakeholders to improve how safely and efficiently we deliver healthcare to our patients," says John F. Di Capua, chair of anesthesiology for the North Shore-LIJ Health System and chief executive officer of North American Partners in Anesthesia.

The introduction of video monitoring in ORs follows its ongoing, successful use in the medical and surgical intensive care units at North Shore University Hospital. In a 2011 study published in Clinical Infectious Diseases Medical Journal, NSUH demonstrated that the use of Arrowsight's third-party RVA system rapidly improved and sustained hand hygiene rates to nearly 90 percent in less than four weeks.

"The recognition and expansion of Arrowsight's RVA technology is a validater for us, showing firsthand what the RVA system has done to improve patient safety and efficiency at North Shore LIJ Health System, not just in the ICU's but now in the surgical department," says Adam Aronson, Arrowsight's chief executive officer.

Source: North Shore-Long Island Jewish Health System

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