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A Holistic Approach to HARM-free Care and Early Detection of Patient Deterioration


on pressure ulcers2 and £2bn on Sepsis4


T


he NHS has identified areas in the Service, where there are very high, but potentially preventable, costs: these include £2bn-£2.3bn on falls1


, £1.4bn- £2.1bn


, £30,000, per person on resuscitation3 , per year. As a tool to reduce these costs


,


BES Healthcare has brought to the UK market ‘EarlySense’. EarlySense is a contact-free sensor which, when placed under a bed, continuously monitors vitals such as heart and respiratory rate, and detects movement. This system has proven to reduce critical ‘code blue’ events, falls, and pressure ulcers in hospitals around the world.


REDUCE ‘CODE BLUE’ EVENTS


Most critical events (such as cardiac and circulatory arrests) are preceded by warnings of trend changes 6-8 hours prior to the event5,6


. Changes in Heart rate and Respiratory rate


are the early indicators of deterioration. By detecting these early changes, the system helps nurses respond to these early warning signs, thereby reducing the costs of ‘code blue’ interventions, and avoiding unexpected deaths7,8


published clinical studies, EarlySense has been shown to be able to reduce the need for resuscitation events by 86%9


REDUCE FALLS


EarlySense can help hospitals meet their patient safety goals of reducing avoidable injuries caused by falls. Most falls occur shortly after bed exits. EarlySense reduced the incidence of falls by 87.2%10


in a hospital in Florida. A clinician in the


hospital also said, “The EarlySense system integrates with the hospital’s current clinical workflows, requiring no additional overhead” 11


. REDUCE PRESSURE ULCERS


EarlySense was evaluated by a team of clinicians on a 33- bed surgical unit which included patients with general medical, trauma, and surgical needs in a community hospital in California12


. The data were collected from 1,000 patients


over a period of six months. Within this period EarlySense helped reduce pressure ulcers (Stage II and above) by 74.7%. (Meanwhile, the overall rate of nurse satisfaction with the system was 84.6%.)


POTENTIAL COST SAVINGS TO THE NHS It is estimated that there are 180,00013


newly developed


pressure ulcers every year, treated at an average cost of £6,00014


per patient. Similarly, the total number of inpatient


falls reported in hospitals in England and Wales is 240,00015 per year. Based on the total number of hospitals and hospital beds, the average cost per bed in treating a patient with a pressure ulcer is £6,50016 fall is £11,80616


, while the average cost per bed for a . If EarlySense were to be implemented in a 10 bed geriatric ward in a hospital trying to reduce falls and/or


. Within .


pressure ulcer incidences, the system would pay for itself by preventing just 5 falls or 6 pressure ulcers. Clinical studies in the US have shown a positive Return on Investment in 6-9 months from the implementation of the EarlySense System17


. Mobile Alerts EARLYSENSE IMPLEMENTED IN THE UK


North Tees & Hartlepool NHS Foundation Trust has taken up the initiative to meet their patient safety goals of reducing falls by implementing the EarlySense system in their elderly care and surgical wards in the University Hospital of North Tees in Stockton. As an early adopter, Steve Heavisides, Ward Matron said, “It has made a real difference to the care we can give to patients particularly during the night where we have seen real improvements in care” 18


. EarlySense can help


support the National Early Warning Score (NEWS) system. The beauty of EarlySense, however, is that unlike NEWS systems which are taking the occasional rear-view snapshot, EarlySense is following trends continuously.


NICE (National Institute of Care and Excellence) has published a review on EarlySense which can be found on the NICE website (search for EarlySense). This review was commissioned by NHS England and produced in support of the NHS ‘Five Year Forward View,’ as one of a number of steps which will accelerate innovation in new treatments and diagnostics.


References 1


2 NICE (2013) Clinical Guideline CG161


Bennett, G et al (2004) Age and Ageing 33, 230-235


3 Dingwall, R et all (2002) Nursing Times 98, 36 4


Department of Health (2015) New actions to reduce sepsis.


5 Schein, R.M. et al (1990) Chest 98, 1388-92 6


Franklin C. & Mathew J. (1994) Critical Care Medicine 22, 244-247


7


Zimlichman (2013), Evaluation of Ever-On as a Tool to Detect Deteriorations EarlySense.com


8


Young, M.P. et al (2003) J Gen Intern Medicine 18, 77–83


9 Brown, HV et al (2013) J Med 127, 226-232 10


Impact of Nursing Safety Initiatives on Patient Outcomes Florida, Tampa (2013)


11


Florida Hospital Tampa is First in the State to Implement EarlySense Proactive Patient Monitoring System (2013). Florida MD


12


Brown, HV & Zimlichman, E (2010) Improved Outcomes and Reduced Costs with Contact-free Continuous Patient Monitoring on a Medical-Surgical Hospital Unit


TM 15 13 14


NHS Improving Quality, Pressure Ulcers (2016)


A guide to eliminating all avoidable grade 2, 3, and 4 pressure ulcers. Nursing Standards (2016)


National Audit of Inpatient Falls (2015). Royal College of Physicians


16 Welsh Government Website (2016) 16 Our NHS Scotland Website(2016) 16 Nuffield Trust Website (2016)


16 Northern Ireland Government Website (2016) 17


Brown et al (2014) Critical Care Medicine 42:1862-8


18


Patient monitors research trial, North Tees and Hartlepool NHS Trust (2016)


To help meet your patient safety goals, there is an opportunity to trial EarlySense in your healthcare facility. Call BES on 01179 666 761. Visit www.beshealthcare.net


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