This document contains proprietary, confidential information of Arrowsight, Inc., and may not be distributed or discussed beyond the original recipient without permission from Arrowsight.
©2017 Arrowsight, Inc. www.arrowsight.com
Remote Video Auditing Webinar
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Introduction
15 Years of Remote Video Auditing (RVA) & Business Intelligence Experience Real-time mobile alerts to managers, live feedback of worker performance, daily reports
Strong track record of driving significant safety & productivity improvements in food manufacturing and healthcare – worker safety, patient safety, food safety
RVA Healthcare Services: Reduce risk of SSIs and HAIs Reduce risk of wrong site surgeries and retained foreign objects Improve patient flow in ORs and throughout hospital Reduce scope related infections
Published Healthcare Studies, Editorials, and Abstracts:
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Arrowsight
Multiple Remote Customer Facilities with Cameras & DVR’s and Remote Video Access
3rd Party Cameras &
DVR’s & Machine Data
Customer Corporate Office with Remote Video Access
3: Daily and Weekly Labor Performance Scorecard Reports E-mailed to Line & Plant Managers
4. Weekly Labor Performance Reports E-mailed to Stakeholders
1: RVA Audits & Live Tours Performed by Arrowsight Auditors
NOC* (US & India)
Facility Site Managers
* NOC = Network Operations Center
Arrowsight Proprietary Internet Hosted Database & Web Servers
2: Real Time Feedback Mediums:Live Data Feeds in Facilities, Text/Email Alerts to Front Line Supervisors
Remote Video Auditing (RVA)Business Process Workflow Diagram
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Hand Hygiene Performance in ICUs Audit Application: Hand hygiene compliance in a 17 bed ICU
Feedback Methods: real-time performance metrics posted to digital boards
Results: Hand hygiene rates rose from ~10% to ~90% in four weeks
Results Published in 2011 CID Study & Cited in 2013 JAMA Editorial
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Patient Privacy – PHI & HIPAA: In operating rooms or ICUs low resolution video is used and no faces or
body parts can be seen Malpractice Liability:
All forms of RVA data reporting are implemented as a “quality improvement initiative” and are labeled with the following language which protects the data from being legally discoverable (this language may vary by state): “Confidential-Education Law 6527, Public Health Law 2805-JKLM”
The video is stored for only 24 hours and is secured in a locked cage onsite in the hospital with only a 3rd party security firm having access to the box; the hospital can only view live video and cannot go back to see recorded video
Unions/HR: All the feedback data is in aggregate form and no individual workers are
singled out
Legal ConsiderationsWhen Deploying RVA in Operating Rooms
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Example of Low Resolution Video
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3rd Party Remote Video Auditing (RVA) OR Patient Safety & Peri-op Services Workflow Diagram
• Cameras installed with low resolution to protect patient and staff privacy• Arrowsight samples each OR every 2 minutes from monitoring centers• Real-time OR status info and OR performance feedback are posted to digital scoreboards in wards and
available as an app on smartphones• Real-time email alerts for timeout variance and OR status changes sent to clinical managers, surgeons and
support staff • Daily performance reports sent to managers
3rd Party Remote Video Auditing
Daily summary reports & text alerts
OR Real-Time StatusReal-Time OR Throughput Metrics
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Remote Video Auditing Structured User Interface
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OR Patient Safety Metrics: • Sign-in Compliance• Time-out Compliance• Sign-out Compliance• Terminal Cleaning Compliance
OR Efficiency Metrics: • Patient Exit to Cleaning Stop
o Patient Exit to Cleaning Starto Cleaning Start to Cleaning Stop
• Cleaning Stop to Room Sterile• Room Sterile to Patient in Room
OR Safety & Efficiency Opportunities
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Real-time Status BoardsDisplayed on Plasma Boards & Smart Phones
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Aggregate Real Time Performance DataDisplayed on Plasma Boards & Smart Phones
Page 11
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Text Messaging / Alerts
Text Alert Team ActionRoom Sterile Anesthesia Room Ready
Patient in Room
Surgeon Come to OR
Drape Down Holding Area PreparePatient
Bed in Room Housekeeping Clean Room
X-Ray Needed Radiology X-ray to OR
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OR Sample Data Analytics
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RVA Daily Dashboard
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1st Case Start Roadmap ToolResults: 300 Minutes/Day of Gained Time
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OR Timeout ImprovementsResults: No Wrong Sited Surgeries Since RVA Inception
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BaselinePeriod 2013
InitialFeedback Q1
2014
Q1 2015 Q2 2015 Q3 2015
Mins
LIJ OR Turnover Time ImprovementsResults: 3% Increase in Surgical Case Volumes with Higher CMI
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2015/2016 BMJ Study & Editorial on RVA in ORsResults: 90%+ OR Safety Compliance & 15%-20% Efficiency Gains
2015 Published
Study
2016 Published Editorial
“This is a landmark study…”
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OR Terminal Cleaning Analytics
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OR Terminal Cleaning Results
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“Best Practices” JCR Educational VideoFeaturing Arrowsight’s RVA Services
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Feb 2017 AORN Journal Article
Summary Results of Published StudyOR surgical safety checklist results
• Timeouts: 90% to 98%• Sign-outs: 70% to 94%
OR Efficiencies• Turnover times reduced from 36 minutes to 30 minutes
– 480 minutes saved per week ($96/min) = full payback in 1 monthOR Cleaning
• Case cleaning: 79% to 93%• Terminal cleaning: 67% to 94%
– SSIs reduced by 10% (later revised to 20%)
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Portable Cameras for OR CleaningResults: 20% Reduction in SSIs
EVS worker places portable camera on wall bracket for in-between case cleaning
& terminal cleaning
EVS worker cleans room EVS worker returns portable camera to the supervisor’s office at end of shift and plugs camera into Internet router
Arrowsight audits OR cleaning performance
and sends daily reports to Peri-op,
ID and EVS managers
Portable, Battery Powered, Self-Recording, Low Resolution Cameras
LEGENDSSI = Surgical Site Infection
EVS = Environmental Services
Peri-op = Perioperative
ID = Infectious Disease
OR = Operating Room
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SSI ROI Calculator
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LIJ Medical Center – Fully Wired Hospital
History of RVA at LIJ 2013 OR Services 2014-2015 added ASC, endo, L&D, dirty work room, scope cleaning, surgical
annex 2016 added hallway cameras throughout building 2017 adding ED
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Dual Use Hallway Mega Pixel Camera Solutions:PPE Compliance & Patient Flow
Isolation Rooms: PPE Donning & Doffing
Compliance Metrics & Alerts
RVA of PPE Compliancefor Isolation Rooms
& RVA of Patient Flow Metrics
Real-time alerts, Intra-shift &
Daily Performance
Metrics
Patient Flow: Discharge > Cleaning > Admission
Time Metrics & Delay Alerts
Dual Use Mega-Pixel Hallway Cameras
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Example of Hallway Camera ViewsMegapixel Camera Wide/Close-up
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2015 Abstract Using RVA Reports Low Baseline PPE Compliance in ICU’s
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Hospital Wide & Floor Level Boards PPE Performance in Isolation Rooms
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Floor Level BoardsPatient Flow Performance
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Scope Reprocessing
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RVA ExampleEndoscope Reprocessing – Daily Report
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Regular Endoscope Cleaning – Clinic Setting Manual Reprocessing Performance
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ADD SCOPE AUDIT DETAILS
Regular Scope – Endo Clinic SettingLeak Test Performance Rates
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RVA Service Options
Short term pilot program for hospitals with existing OR cameras to assess unbiased patient safety & efficiency performance
EVS cleaning program for both ORs and/or isolation rooms using portable cameras
Scope reprocessing (cleaning) program
Full patient safety and patient flow efficiency programs for ORs and other clinical areas through hospitals
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Contact Information
Adam AronsonChief Executive OfficerArrowsight, Inc.Phone: [email protected]
Dr. Brian SchurginChief Medical OfficerArrowsight, Inc.Phone: [email protected]
Michael GoldbergExecutive DirectorLIJ Medical CenterNorthwell HealthPhone: [email protected]
Dr. Sheldon NewmanExecutive Vice Chair of AnesthesiaLIJ Medical CenterNorthwell HealthPhone: [email protected]
