 Last November the Centers for Medicare and Medicaid Services (CMS) required facilities to document the use of bed and chair exit alarms. Many see this as the first step in an effort to ban their use, treating them as a form of restraint. If you bring this up among professionals, you’re bound to hear an interesting and engaging debate. Some are a firm yes, others are no, and many are somewhere in between. The overwhelming argument against the use of alarms is the noise they make, and few if any disagree with this. Imagine trying to sleep when every movement causes an alarm to blare out and staff to rush into your room? It’s terrible, and many studies have shown that audible alarms cause more falls than they prevent. They scare residents, disturb sleep, and confuse caregivers who can’t tell what room the alarm is coming from. The secondary argument is that alarms create negligence among caregivers. Using this logic any alarm is bad because it teaches staff to be reactive, rather than understand and anticipate a residents needs. There is a lot of debate around this reasoning. Does a tool like an alarm create negligence, or is it organizational culture?
Another less philosophical issue with alarms is alarm fatigue. Studies have shown that traditional alarms are as low as 60% accurate, leading to many false alarms. When 40 out of every 100 alarms is false, staff learn to quickly ignore them. The encouraging news is that new technology can help make alarms silent and more accurate. These are not insurmountable problems, and in fact this is something we’re doing at upBed today. The discouraging news (for us) is that we’re not sure how to solve the perceived negligence problem. Is it a problem? Our view of this is a bit skewed, but it goes something like this. If you are doing 15 minute rounds, what happens during the 14 minutes you’re not watching the resident? There is real risk and problem here, and if a silent alarm exists that is 100% accurate wouldn’t this be a good thing? Better yet, what if the same underlying technology could learn to predict when someone will wake up, giving caregivers advanced notice. Is this an alarm? Does this create negligence? These are interesting questions. Our macro concern is that far-reaching legislation to ban all alarms could stifle innovation that the healthcare space desperately needs. But we’re interested in learning from your opinion. Where do you stand on this debate and how are you responding to it?
0 Comments
 We had a great time at the LeadingAge Maine & New Hampshire conference this year held in Portsmouth. We always learn so much at these events, both about healthcare and the people that make it work. Amy Dee kicked off the conference with a laugh out loud keynote. I think it made most of the men (me included) in the audience slightly uncomfortable, but in a good way. It was fantastic!
We really enjoyed the campfire sessions, as well as the innovation discussions. The topics spread the gamut, from HR/recruiting, to new technology for care, to how to use data and analytics to improve performance. It was really interesting listening in on the discussions around technology. The basic message is that technology change is coming, and you need to start learning and planning for it. At upByte we see this as well, but it's encouraging to see the same message being spread by others. One amazing source of information that we learned about at the conference is CAST (Center for Aging Services Technology). Dr. Majd Alwan, is the Executive Director, and CAST represents a wealth of information on technology trends, available technology, and best practices for adoption. This is a fantastic resource for care providers, and one that we will reference and help with if we can. At the conference I gave a presentation on "Using Technology to Improve Resident-Centered Care". If you're interested you can find the slides via the link above, along with other presentations from the conference. Thank you LeadingAge for a great conference! We’ve all heard the story. A young nurse brings a smartphone to work. They snap a selfie to share with friends on Facebook, but don’t see the resident sitting in the background. HIPPA laws busted.  Directors at LTC facilities will often site this example, or explain how distracting they are to the staff. Texting friends, checking social feeds, email, and many of the other tasks we perform on our personal phones have nothing to do with work. IT professionals can get away with it sitting at their cubicle, but nurses don’t have the luxury. It’s a demanding job, demanding their full attention.
The simple solution for most Directors is to not allow phones. Or is it? We’ve encountered this a lot when speaking with nursing homes about upBed and technology like it. When we say “sends a text message to your phone”, there is good that this causes problems. We get responses like…
To get around this we offer phones specifically for our app that are low end so no-one would want to do much else with them. This seems OK, but it begs the question. When will it become common for nursing homes to use mobile devices? Some do. They provide a phone to the head nurse to contact doctors, or tablets to staff for charting. A very few allow personal phones with general etiquette on how and when to use them. But these are a dime a dozen, at least in Maine. Being new to healthcare, I'm interested in what you think? What’s holding facilities back the most? Will it ever be common? Or worse, how much longer will these pagers exist? Please don't make me write code to talk to your pager. I'll do it, but please!
Join us for the Maine Health Care Conference next week, October 3rd to the 5th in Rockport, Maine. We'll have an upBed booth and our own Aron Semle will be leading a discussion on "The Impact of Technology on Patient Care" on Wednesday at 2PM. There are a lot of amazing technologies on the horizon for resident homes, so lets start the discussion on what these could look like and best practices in adoption.
We're excited to attend the conference, hear about the great work Maine resident homes are doing, and get feedback on our latest design of upBed. It's our first healthcare conference and it will be a great one. Hope to see you there! |
