Other Titles
PechaKucha Presentation
Abstract
A quality improvement project was implemented, focused on increasing utilization of the virtual monitoring unit (VMU) to reduce patient falls. For a three-month period, there were 208 patient falls. Fifty-nine and a half percent of these patients met virtual monitoring criteria but did not have it implemented. Review of the electronic health record (EHR) flowsheet discovered challenges for the nurse to effectively identify patients who met criteria, leading to underutilization of this safety resource. Analysis found nurses were implementing VMU based on subjective reasoning instead of objective criteria, leading to inadequate observation of patients and increased falls.
Outcomes: After receiving feedback from nursing staff concerning the lack of clarity about eligibility for virtual monitoring, this project optimized the nurse’s workflow by rearranging flowsheet rows in the EHR and adding initiation criteria to the sidebar.
May ’23-July ’23: There were 208 patient falls (avg 2.26 falls/day). Eighty-nine of those met virtual monitoring initiation criteria but monitoring was not implemented on 53 (59.5%).
August’23 the optimized EHR flowsheet was initiated in all units with VMU capability with an expected outcome of patient fall reduction. The initial 20 days of project implementation found a total of 34 patient falls (avg 1.7/day), 19 of those met initiation criteria, with eight (42.1%) not having VMU implemented as expected. This was an overall 17.5% increase in virtual monitoring compliance and a 24.8% decrease in average daily falls.
Comparison data will be monitored for three months post implementation to determine if the intervention continued to reduce fall rates and increase utilization of virtual monitoring for those that met criteria.
Implications: The project highlights the importance of leveraging technology to optimize patient care. Improved VMU utilization through EHR optimization can serve as a model for other patient safety initiatives, providing valuable insights for healthcare institutions aiming to enhance safety and quality.
Application to Other Settings: The insights gained from this project are applicable to various healthcare settings, regardless of their size or patient population. By implementing similar changes to improve the visualization of key criteria, other institutions can also enhance EHR workflows to improve patient quality and safety.
Lessons Learned: As a LEAN organization, utilizing Gemba philosophy to improve workflow efficiency is critical to process improvement. The engagement of frontline clinical staff in the design and implementation of this initiative was invaluable.
Practical Takeaways: Staff input is critical when trying to solve issues. By taking time to learn about their challenges, this organization was able to create processes to help support nursing workflow and to improve patient safety and quality.
Notes
The slide deck contains the author's notes.
References:
Chipps, E., Tucker, S., Labardee, R., Thomas, B., Weber, M., Gallagher-Ford, L., & Melnyk, B. M. (2020). The impact of the electronic health record on moving new evidence‐based nursing practices forward. Worldviews on Evidence-based Nursing, 17(2), 136–143. https://doi.org/10.1111/wvn.12435
Davis, J. E., & Carter-Templeton, H. (2020). Augmenting an inpatient fall program with video observation. Journal of Nursing Care Quality, 36(1), 62–66. https://doi.org/10.1097/ncq.0000000000000486
Mills, S. A. (2019). Electronic health records and use of clinical decision support. Critical Care Nursing Clinics of North America, 31(2), 125–131. https://doi.org/10.1016/j.cnc.2019.02.006
Quigley, B., Renz, S., & Bradway, C. (2021). Fall prevention and injury reduction utilizing continuous video monitoring. Journal of Nursing Care Quality, 37(2), 123–129. https://doi.org/10.1097/ncq.0000000000000582
Saraswasta, I. W. G., & Hariyati, R. T. S. (2021). A systematic review of the implementation of electronic nursing documentation toward patient safety. Enfermería Clínica, 31, S205–S209. https://doi.org/10.1016/j.enfcli.2020.12.023
Sigma Membership
Tau Psi at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Quality Improvement
Research Approach
Other
Keywords:
Patient Falls, Virtual Monitoring Unit, VMU, Technolog, Electronic Health Record, EHR
Recommended Citation
Menter, Valerie E. and Williamson, Brittney L., "We See You! Increased Focus on Implementing Virtual Monitoring" (2026). Creating Healthy Work Environments (CHWE). 7.
https://www.sigmarepository.org/chwe/2024/presentations_2024/7
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Washington, DC, USA
Conference Year
2024
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-02-10
We See You! Increased Focus on Implementing Virtual Monitoring
Washington, DC, USA
A quality improvement project was implemented, focused on increasing utilization of the virtual monitoring unit (VMU) to reduce patient falls. For a three-month period, there were 208 patient falls. Fifty-nine and a half percent of these patients met virtual monitoring criteria but did not have it implemented. Review of the electronic health record (EHR) flowsheet discovered challenges for the nurse to effectively identify patients who met criteria, leading to underutilization of this safety resource. Analysis found nurses were implementing VMU based on subjective reasoning instead of objective criteria, leading to inadequate observation of patients and increased falls.
Outcomes: After receiving feedback from nursing staff concerning the lack of clarity about eligibility for virtual monitoring, this project optimized the nurse’s workflow by rearranging flowsheet rows in the EHR and adding initiation criteria to the sidebar.
May ’23-July ’23: There were 208 patient falls (avg 2.26 falls/day). Eighty-nine of those met virtual monitoring initiation criteria but monitoring was not implemented on 53 (59.5%).
August’23 the optimized EHR flowsheet was initiated in all units with VMU capability with an expected outcome of patient fall reduction. The initial 20 days of project implementation found a total of 34 patient falls (avg 1.7/day), 19 of those met initiation criteria, with eight (42.1%) not having VMU implemented as expected. This was an overall 17.5% increase in virtual monitoring compliance and a 24.8% decrease in average daily falls.
Comparison data will be monitored for three months post implementation to determine if the intervention continued to reduce fall rates and increase utilization of virtual monitoring for those that met criteria.
Implications: The project highlights the importance of leveraging technology to optimize patient care. Improved VMU utilization through EHR optimization can serve as a model for other patient safety initiatives, providing valuable insights for healthcare institutions aiming to enhance safety and quality.
Application to Other Settings: The insights gained from this project are applicable to various healthcare settings, regardless of their size or patient population. By implementing similar changes to improve the visualization of key criteria, other institutions can also enhance EHR workflows to improve patient quality and safety.
Lessons Learned: As a LEAN organization, utilizing Gemba philosophy to improve workflow efficiency is critical to process improvement. The engagement of frontline clinical staff in the design and implementation of this initiative was invaluable.
Practical Takeaways: Staff input is critical when trying to solve issues. By taking time to learn about their challenges, this organization was able to create processes to help support nursing workflow and to improve patient safety and quality.
Description
This quality improvement project focused on increasing utilization of the virtual monitoring unit (VMU) to reduce patient falls. Attendees will gain practical insights to enhance VMU utilization by optimizing EHR flowsheet visualization of key criteria to produce a positive impact on patient safety outcomes and financial stewardship for healthcare settings.