This document discusses common challenges in healthcare including clinical, financial, and managerial issues. Clinically, there are increased patient acuity, age and deterioration without adequate monitoring leading to issues like pressure ulcers and falls. Financially, there are concerns around increased ICU length of stay, overuse of telemetry and ICU beds, and reimbursement cuts for adverse events and readmissions. Managerially there are issues with staff accountability, inadequate management tools, alarm fatigue, and readmission prevention. The document advocates for first improving efficiency, effective care, safety, coordinated care, and reducing cost-related problems.

1. Leyton Stevens
Chief Executive
BES Corporate

2. Common Challenges
Clinical:
• Increased acuity & age
• Deteriorating patients with
inadequate monitoring
• Pressure ulcers
• Patient falls
• No increase in staff
Financial
• ICU length of stay
• Increased demand for
Telemetry & ICU beds
(overused?)
• Reimbursement cuts on
adverse events & readmitted
patients
Managerial
• Staff accountability
& critical thinking
• Inadequate management
tools
• Alarm fatigue
• Patient discharge and
readmission prevention
Multi-faceted Challenges in Healthcare

3. ❖ First for efficiency
❖ 1st for effective care
❖ 1st for safety of care
The Commonwealth Fund
2014
❖ 1st for co-ordinated centred care
❖ 1st for cost related problems

4. • Cost of treating pressure ulcers: £2.1bn annually1
NHS Statistics
1. Bennett, G et al (2004) The Cost of Pressure Ulcers in the UK
2. National Institute for Health and Care Excellence (2013) Falls: the assessment and prevention of falls in older people
3. Tian, Y et al (2013) Exploring the system wide cost of falls in Torbay
4. NHS Confederation (2016) Key Statistics on the NHS
5. Data.Gov.UK (2015) Department of Health: NHS Hospital Stay
‘Harmsfree’campaign
• Cost of falls to the NHS: £2bn annually2
• Falls in hospitals accounted for 324,000 (26%) of all patient safety
incidents3
• Patient deterioration
• Average length of stay in hospital: 7 days4 with per bed day cost £4005

6. My mum
My mum is 88 years young
My mum falls over….. A lot!

7. What is EarlySense Insight?
Around the clock care,
bed and chair sensors

8. Contact-Free Sensor
What is EarlySense Insight?
Heart Rate
Respiratory rate
Motion

9. EarlySense Insight

10. The EarlySense Insight Chair Sensor
“Since we started using the chair sensor we
have had zero patient falls from chairs...”
(August 2014)
S. Hughes, RN. Director of Medical
Surgical
Coffee Regional Medical Center,
Douglas, GA

11. 87%
EarlySense Insight Benefits
Reduction in Code Blue events
Reduction in Pressure Ulcers64%
Reduction in Falls44%
Reduction in Length of Stay9%
Based on a 7,643
Patient Clinical Trial

12. What are the costs?
Falls
• Pearson, K.B. & Coburn, A.F. Evidence-based Falls Prevention in Critical Access Hospitals. 2011.
• Australian Commission on Safety and Quality in Healthcare (ACSQHC). Preventing falls and harm from falls in older people: best practice guidelines for Australian community
care. Canberra (ACT): Commonwealth of Australia, 2009.

13. Reducing the incidence of falls

14. 87%
EarlySense Benefits
Reduction in Code Blue events
Reduction in Pressure Ulcers64%
Reduction in Falls44%
Reduction in Length of Stay9%
Based on a 7,643
Patient Clinical Trial
Reduction in Pressure Ulcer Incidence

15. What are the costs?
Reduction in Pressure Ulcer Incidence
• Cost of litigation £180,000 per case on average
• £2 billion pa
• 4% of total NHS budget
• Prevalence of Hospital Acquired Pressure Ulcers is 5% in acute care settings1
• Treatment costs: up to £40,000 an ulcer
1 Lyder et al. Hospital-acquired pressure ulcers: results from the national medicare patient safety monitoring system study. J
Am Geriatr Soc. 2012 Sep;60(9):1603-8.

16. What are the costs?
Reduction in Pressure Ulcer Incidence
1 Lyder et al. Hospital-acquired pressure ulcers: results from the national medicare patient safety monitoring system study. J
Am Geriatr Soc. 2012 Sep;60(9):1603-8.
Pressure ulcers are considered to be preventable;
and Hospital Acquired Pressure Ulcers (HAPU)are
commonly perceived as an indicator of
quality of care
• Stay in hospital longer - 136% higher average length of stay
• More likely to be readmitted within 30 days - 33% more
• More likely to die during their hospitalisation: 2.81 times (181% more)
Patients with HAPU compared to patients without HAPU are1

17. Reducing the incidence of Pressure
Ulcers

18. 87%
EarlySense Benefits
Reduction in Code Blue events
Reduction in Pressure Ulcers64%
Reduction in Falls44%
Reduction in Length of Stay9%
Based on a 7,643
Patient Clinical Trial
Reduction in Pressure Ulcer Incidence

19. Vitals tracking
Critical events are estimated to occur in up to 17%
of patient admissions1
1. The Joint Commission Guidelines
2. Schein R.M. et al, Chest 1990; 98: 1388-92.
3. Franklin C. & Mathew J. Critical care medicine 22, 244-247
4. Young MP et al, J Gen Intern Med. 2003; 18: 77-83
5. Chaboyer W et al (Amer J of Critical Care. 2008;17)
6. Churpek, M et al. (Chest: 2012;141)
Significant number of
critical events are
preceded by warning
signs 6 to 8 hours
prior to the event1
• Heart and Respiratory Rates are most
valuable early detectors of deterioration
risk5,6
• Responding to early warning signs reduces
mortality by 75% and cost by 40%4
• 66% of patients have abnormal symptoms
6 hours before cardiac arrest and the
doctor is informed only in 25% of these
patients3
• 70% of patients have respiratory problems
within 8 hours prior to circulatory arrest2

20. Cardiac Arrhythmia – Case Study
About the Patient:
A 55 year old female with metastatic Lung Cancer. History of
Pneumonia, Embolus and Stroke. Hospitalised for over a month
awaiting rehab placement.
EarlySense Indication:
7:30 AM: High HR alerts (180’s BPM)
Assessment:
Complaints of palpitations and light headedness. The patient
had not reported this, thinking it a symptom of her condition. An
ECG was undertaken and an Atrial flutter identified.
Response:
Suitable medication was prescribed
Outcome:
The patient returned to normal sinus rhythm.
High Heart Rate Alert Leading to Identification of Atrial Flutter and
return to Normal Sinus Rhythm
Med-Surg Dep., MA, USA
Lines Icons
Respiratory Rate
Heart Rate
High Heart Rate Alert
Multiple Alerts

21. EarlySense cost comparison
With EarlySense
(33 beds implementation)
Without EarlySense
(90 beds)

22. Any Questions?