Better monitoring saves lives and money: Improving patient safety through improved patient monitoring More than wireless remote vital sign monitoring In 2013, the National Institute for Health and Care Excellence (NICE) reported that patients and their families should feel that a hospital was a place of care and comfort, somewhere they would be looked after1. It suggested that monitoring patients by checking them and their health regularly while they were in hospital and taking action if they showed any signs of becoming worse would help avoid more serious problems. Unfortunately, NICE’s evidence of the reality of hospital care pointed to the contrary. The report found that patients who are, or become, acutely unwell in hospital may receive suboptimal care2. This may be because deterioration in their condition is not recognised or despite indications of clinical deterioration, the seriousness of their condition is not appreciated nor not acted upon sufficiently rapidly. Communication and documentation are often poor, experience might be lacking and provision of critical expertise, including admission to critical care areas, may be delayed. The report said the key priorities for implementation included:  A clear written monitoring plan which specifies which physiological observations should be recorded and how often  A physiological track and trigger system should be used to monitor all adult patients in acute hospital settings and physiological observations at least every 12 hours, unless a decision has been made at senior level to increase or decrease their frequency for an individual patient. Why is patient safety relevant to healthcare and how can patient monitoring help? There is now overwhelming evidence that significant numbers of patients are harmed from the healthcare they receive resulting in permanent injury, increased length of stay in hospital or even death. We have learnt over the last decade that adverse events occur not because people intentionally hurt patients but rather that the system of healthcare today is so complex that the successful treatment and outcome for each patient depends on a range of factors, not just the competence of an individual healthcare provider. When so many people and different types of healthcare professionals (doctors, nurses, pharmacists, social workers, dieticians and others) are involved this makes it very difficult to ensure safe care, unless the system is designed to facilitate timely and complete information and understanding by all the health professionals3. NICE Guidelines, Introduction, 2007, reviewed December 2013, http://www.nice.org.uk/guidance/cg50/chapter/introduction NICE Guidelines, Introduction, 2007, reviewed December 2013, http://www.nice.org.uk/guidance/cg50/chapter/introduction 3 http://www.who.int/patientsafety/education/curriculum/who_mc_topic-1.pd

It is now widely accepted that 1 in 10 patients admitted to hospital will be unintentionally harmed in some way4. To put that into context in the extreme case, there are more deaths annually as a result of the care people receive than from road accidents, breast cancer and AIDS combined. Some of these adverse events will be inevitable complications of treatment, however, at least half of these events are thought to be preventable. Although the 10% figure of harm happening to admitted patients is well known, this level of error would be completely unacceptable in many other industries (eg aviation),...

One of the traditional roles of doctors and in particular nurses involves patient surveillance. This includes checking patients for changes in their condition, recognising early clinical deterioration and protection from harm or errors.18 It is well documented that prompt detection and reporting of changes in these vital signs is essential, because delays in initiating appropriate treatment can detrimentally affect the patient’s outcome19. For more than 100 years, nurses have performed this surveillance manually and have used a paper-based system to record patients’ vital signs: temperature,...

A comprehensive remote patient monitoring program collects, transmits and analyses key biometric and behavioural data, generates alerts when an intervention is needed, and delivers meaningful information to a single page on the care team’s secure web portal. The patient’s care team can then use this real-time data continuum to proactively connect the patient with the right intervention at the right time, whether they are in hospital or in other care settings, including the home. Isansys Lifecare has developed an award-winning digital platform that will significantly improve patient safety. The...

The Patient Status Engine has the capability to monitor and analyse physiological data faster, and in more detail in order to provide a rich source of knowledge that can be used to ensure adherence to clinical guidelines with real time alerts. These technologies can also help to reduce the costs associated with avoidable patient deterioration, medical errors, readmissions to intensive care wards and admissions (and readmissions) to hospital and, most importantly, save lives.