Virtual Observation: A Second Set Of Eyes For Short-Staffed Hospitals


If you’ve ever had to stay in a hospital overnight, you’ve likely experienced the frustration of waiting. Whether for your medication, receiving tests, or even being discharged, you have probably noticed a bustling staff move continuously between nursing stations and patient rooms and wondered, why don’t they hire more people? Most hospital administrators will give you the same answer: budget.

For those hospitalized long-term or for critical care, overstretched staff can mean an additional layer of risks for patients that may include falls, various forms of self-harm, or even elopement. These challenges are increasing within facilities across the country. However, technology is bringing new solutions to healthcare. Virtual patient observation is a promising answer to solving staff shortages.

Challenges in Healthcare

While budgetary constraints are minimizing the number of nurses hired each year, hospital staff experience increasingly greater strain, particularly since the onset of COVID-19. Even without the more severe and continuous threat of the virus, hospital clinical staff—nurses, in particular—are finding themselves dealing with larger numbers of falls and other adverse events simply because there are too many patients for onsite clinicians to observe efficiently. Higher patient loads are associated with rising hospital readmission rates, as studies show that assigning four or more patients to a single RN significantly increases the likelihood of readmissions.1

The growing number of clinicians leaving the healthcare workforce has resulted in a significant nursing shortage. The physical and emotional fatigue within the nation’s healthcare organizations led to a 95.7% increase in RN turnover in the past 5 years.2

Unfortunately, a shortage of RNs will continue spreading across the United States through 2030.3

A Case for Patient Safety

At one time, patient care technicians could provide sufficient support by checking in with patients as they carried out their duties. However, higher admissions have rendered one set of eyes to be insufficient. Thus, the patient observer role was introduced to ensure those receiving care could be properly monitored to proactively prevent high-risk behaviors. However, a single observer assigned to one patient provides insufficient support to an RN.

Patient Falls occur every year in U.S. hospitals at a rate of 700,000 to 1,000,000, with roughly 250,000 leading to injury. Injuries occur in up to 35% of patients who’ve suffered falls and can add more than 6 days to a hospital stay. The average cost of a fall with injury is more than $14,000 per patient.4

The Virtual Patient Observation Solution

With Collette Health’s technology, virtual patient observation can now be utilized to address issues by allowing one person, a virtual patient observer (VPO), to monitor as many as 12 patients in one setting. A VPO is off-site and uses Collette Health’s virtual observation software to create a two-way audio/video connection in patients’ rooms via a mobile cart. The virtual observation via the hospital’s secure internet connectivity allows the VPO to monitor 12 patients simultaneously. The solution enables the VPO to communicate interactively with each patient using their voice or with tools like cross-language communication, on-screen captions, and American Sign Language.

In addition to tools that allow two-way communication, the VPO can watch for anything that may help prevent a patient from causing harm to themselves or others. Cameras allow a close-up view of the patient with zoom-in and-out panning to catch potential conditions for adverse events like falls. At the same time, privacy settings may also be implemented so that the patient feels comfortable while being observed.

If an event like a patient fall, IV interference, or wandering is predicted, the VPO can utilize tools to alert onsite nurses while also communicating with the patient for things such as directing them to wait for their nurse and alerting them to possible dangers. Sometimes, simple things like warning patients they are too close to the edge of their bed or advising them to remain in their room can prevent harm. At the same time, reporting tools allow VPOs to record issues via note-taking or snapping photos of the patient rooms. The information they share with the clinical staff or other VPOs can help make all care providers aware of things to watch for with a particular patient.

Virtual patient observation has dramatically affected the risks and issues hospitals and clinical facilities have been struggling to prevent for years. Many large healthcare systems that utilize Collette Health’s technology report an average 68% reduction in patient falls and 12:1 labor cost savings. The extra sets of eyes support nurses who’ve previously been burdened with fatigue, relieving them of needing to be in two or more places at once. Above all, the result is a major increase in patient safety.

Tubbs-Cooley HL, Cimiotti JP, Silber JH, et al. An observational study of nurse staffing ratios and hospital readmission among children admitted for common conditions. BMJ Quality & Safety 2013; 22:735-742.