Five Key Takeaways on Video-Based Patient Monitoring for Preventing Falls

ECRI named ongoing challenges related to patient falls as one of its 2024 Top 10 Patient Safety Concerns because falls continue to be the number one sentinel event reported to the Joint Commission despite the focused attention given to their frequency and severity.  Fall prevention was also a 2023 National Patient Safety Goal for both hospitals and long-term care facilities because between 700,000 to 1 million hospitalized patients and about 800,000 nursing home residents fall each year.

While patient falls may not be completely eliminated within healthcare settings, person-operated video monitoring systems can reduce fall incidence, fall-related injuries, and operational costs, according to a recently published ECRI Clinical Evidence Assessment.

Since 2012, hospitals have been using live-stream cameras and two-way communication systems allowing staff (i.e., tele-sitters) to monitor multiple patients who may attempt to get out of bed or engage in other potentially harmful behavior. Video-based monitoring reduces the need for healthcare facilities to hire or use staff as dedicated sitters for at-risk patients.

Some video monitoring systems have microphones that allow remote tele-sitters to directly speak to patients and redirect their behavior or have the ability to send alerts to nurses’ mobile phones or notify staff by sounding an alarm.

ECRI’s Clinical Evidence Assessment

To understand how video-based monitoring of high-risk patients compares with other options (e.g., dedicated sitters, frequent rounding, bed alarms) intended to reduce fall risk and fall-related injuries in inpatient healthcare settings, ECRI reviewed seven pre- and post-implementation studies and two survey studies published in the last five years.

The studies revealed positive results, including a decrease in falls and an increase in staff satisfaction when using video monitoring. One study showed a 100% decrease in falls—from 2.6 to 0 falls per 1,000 patient days—after video-based monitoring was implemented using observation units with two-way communication and patient sitters. Savings after implementation resulted in $78,000 from fall reduction costs and $10,000 in staffing costs.

Nurse acceptance of video monitoring was favorable in all studies, including one report that showed 81% of nurses believed remote video monitoring assisted with fall prevention and 68% said  between one and three falls were prevented while patients were under surveillance.

Five Key Takeaways

1. Clinical studies evaluating person-operated monitoring systems for video-based monitoring of select high-risk patients before and after implementation consistently showed that it reduced fall incidence and fall-related injuries.
2. Video-based monitoring decreases healthcare costs associated with fall-related injuries.
3. Video-based monitoring reduces the need for healthcare facilities to hire or use staff as dedicated sitters for at-risk patients.
4. Automated video monitoring systems using artificial intelligence to predict fall risk have recently emerged.
5. Several notable clinical practice guidelines recommend that healthcare facilities develop personalized fall prevention strategies based on individual patient risk factors, behaviors, and situations.

Although the study evidence was consistent, the results may be prone to bias and need to be confirmed in studies that assess the benefits of direct monitoring along with patient groups and report on fall frequencies, injuries, direct costs related to falls, and quality of life. ECRI identified no published guidelines that specifically discussed video-based monitoring for fall prevention.

ECRI members may access this Clinical Evidence Assessment through ECRI’s web portal. Nonmembers may learn more about Clinical Evidence Assessment and request additional information.