Eyal Zimlichman, M.D., MSc., holds dual appointments as Deputy Director General and Chief Quality Officer at Sheba Medical Center in Israel and at the Center for Patient Safety Research and Practice at Brigham and Women’s Hospital and Harvard Medical School.
In an in-depth discussion with the Physician-Patient Alliance for Health & Safety (PPAHS), Dr. Zimlichman discusses his research, experience, and thoughts on continuous electronic monitoring. He says that his research of a continuous electronic monitoring system has shown a 6-month break-even point for acquisition and implementation, and thereafter cost savings. To listen to the interview with Dr. Zimlichman on YouTube, please click here.
Research by Dr. Zimlichman and his colleagues has shown significant patient benefit, as well as a return on investment, when using continuous electronic monitoring:
- In “Continuous Monitoring in an Inpatient Medical-Surgical Unit: A Controlled Clinical Trial,” continuous electronic monitoring “on a medical-surgical unit was associated with a significant decrease in total length of stay in the hospital and in intensive care unit days for transferred patients, as well as lower code blue rates.”
- In “The Return on Investment of Implementing a Continuous Monitoring System in General Medical-Surgical Units,” implementation of a continuous electronic monitoring system was “associated with a highly positive return on investment.”
The continuous electronic monitoring system used by Dr. Zimlichman in his research tracked heart rate, respiratory rate, and patient motion:
In the interview, Dr. Zimlichman spoke about the need and benefit of early detection of patient deterioration. Dr Zimlichman:
… mostly in general floors, we have intermittent vital signs checks. These checks would go and somewhere between every six hours or even eight hours or sometimes four hours, but certainly not continuous …
So by the time of intervention between one vital sign check to the other, we actually would get to the patient bedside only when he goes into cardiac arrest, if that deterioration occurs. So being able to continuously monitor patients on general floors, much like we do on ICUs, could be something that would make a significant contribution to preventing these preventable deaths inside hospitals.
Dr. Zimlichman thinks that in the future every hospital bed will have continuous electronic monitoring. However, the same equipment may not be the same at every bed. He believes that clinicians need to choose the continuous electronic monitoring equipment that matches the particular medical unit:
I think it’s my notion that maybe ten years from now, we’ll be seeing continuous monitor ing on every bed in the hospital. It’s industry’s responsibility and ours as researchers to find the right technology to the right setting.
So, just taking ICU monitors and just putting them on every bed in hospital, of course, is not the right solution. We have to find the suitable monitors for the general floors, maybe other monitors for the emergency department or for a gastroenterology suite. So every kind of location needs to have the technology that fits that location.
And then beyond the hospital, of course, as we go through hall monitoring, and that’s also one of the fields that’s been progressing rapidly in the last few years. We need to figure out better how to do continuous monitoring at home, how to identify those trends and alerts with those trends and react early to signs of deterioration. So, I think we’re entering a very exciting field and exciting time that would show us a lot of improvement in preventing preventable deaths which of course is something we’re all aiming for.
Do you agree with Dr. Zimlichman? Please tell us your experience with continuous electronic monitoring.
To read a transcript of the interview with Dr. Zimlichman, please click here.
To listen to the interview with Dr. Zimlichman on YouTube, please click here.