We wanted to see how we could prioritise alerts and improve response times at Elmhurst Short Stay, and further reduce the number of times people staying with us have falls. We were also keen to reduce disturbances to people’s sleep that physical checks can have.
The alert system we had sent out noisy, general alerts to the whole building and if we needed to run a report, we couldn't access the information ourselves; we had to pay for an individual report to be produced and the data in it was very limited.
Because we have people coming to stay for relatively short periods of time, sometimes with quick changeovers, we want to be flexible and responsive to what they need while they're staying; if someone needs to get in and out of bed on a particular side, for example. This responsiveness isn’t possible with some systems, which can take weeks to learn a room layout or update over lengthy periods of time, whereas we can update Sensio ourselves whenever we need to.
The team were immediately impressed with what Sensio could do, both now and with its potential for future developments. The sensor is fitted in the bedroom and monitors its door, the bathroom door and the bedroom space. It doesn't monitor the bathroom but we can set an alert to go off if someone is in there for more than a certain length of time. If someone wants their bed or other furniture in a particular place in the room, we can move furniture around and then update the room layout in the system, so it's updated immediately.
Sensio’s alert methods are much less intrusive and more precise than our previous system, so it helps us maintain people's privacy and dignity.
When someone comes to stay with us, we'll set one alert for falls and one for sitting up in bed. We can also set additional alerts; for example, to help us manage people's pressure sores we can set an alert to tell us if someone goes a certain length of time without moving in bed. If someone stays with us who has dementia, we can set alerts to check whether they're walking with purpose, so we know when they're likely to try going into other rooms.
If someone who's staying with us doesn't need all the alerts in place, it's simple to review and update them. When someone first comes for IMC (intermediate care) we might put the maximum alerts on their room sensor, but as their health improves or their goals change, we can tailor and reduce the alerts, increasing the non intrusive observations, as another step on the way to them going back home where they won't have someone checking on them night and day.
People can opt out of using Sensio too; we can deactivate the sensor in their room and not set any alerts. Either way, people can also have a wearable call pendant if they choose.
Each staff member has a unique login, so we can select which areas of the building they will get alerts for on each shift. The alerts for that building area will go to the same mobile device Care Control (our care management software) uses so just one, portable handset does everything that staff member needs during their shift and it's easy to flick between the two systems, mirroring the digital checks they're doing in both. We decided not to put Sensio on the tablet we use for EMAR though, so that staff helping people with their medication aren't distracted and other team members are still free to respond to alerts.
We've set some general calls to go directly to senior staff too. There are screens in the seniors' office with updates in real time, so you can even see the bedroom door opening when staff answer an alert. Our response time to the alerts is continuing to improve as staff get more used to the technology. They've really embraced it.
When staff get an alert, they get a 62 second live screen view of the bedroom so they can see if anyone needs support without going into their room unnecessarily. The image is anonymised and not recorded or saved, to protect people's privacy. The sensor's very sensitive; it’s triggered when anything at all is put on the floor, so you can either pause the sensor with a physical tag or you can turn it off on the system for a certain amount of time. This is helpful while rooms are being cleaned as well as for any time that people need privacy.
Reporting on Sensio is clear and detailed - when an alert activates, managers can see which phones the alert has gone to, who's handled it and in what timeframe. Sensio creates a live graph over a 24 hour period, so it's really easy to select a certain time or movement, to check when someone has moved around or gone into a bedroom.
The reports can be really helpful to reassure friends, relatives and carers too. If someone staying with us is telling their family that they've been calling for help for 25 minutes, for example, we can check on Sensio whether the calls have been answered. We can also check the details in Care Control that will tell us how staff have answered an alert and checked that the person is ok, whether or not they had to physically go into the bedroom.
Now that staff have got used to being able to check on people remotely first, they are finding it's much easier to see where people are when they do need urgent help. So if someone uses their call pendant, we can check quickly whether they're in their bedroom or not, so we know where to look for them.
It leaves us more quality time to spend with people we're supporting because no one is spending their time running from one end of Elmhurst to the other to answer alerts. We also know when someone has picked up an alert, so everyone else can carry on with what they were doing. This is particularly impactful in IMC, where we can spend more time with people, promoting their independence on day-to-day tasks and getting them ready to go home sooner.
Our biggest hurdle has been changing our mindset - getting out of the habit of going into people's rooms to ask them if they're ok. If someone wants those physical checks we can do that and we will always ask people what they'd prefer, especially overnight. We can make people's preferences really clear on the system for staff too. But we do aim to check digitally first, because one of our goals with Sensio was to reduce disturbances to people's sleep and we can't get a true sense of that if we keep going into people's rooms.
We did hear some concerns about privacy from people staying with us before the system was put in; we spoke to everyone who was staying with us at the time and listened to what their friends and relatives had to say too. With help from Sensio, we put together a leaflet explaining exactly how the system worked and addressing people's specific concerns. The feedback we've had since has all been positive and we make it clear that if people want to opt out, they can.
We're looking forward to seeing how much of a total reduction there is in people's falls, particularly unobserved falls, during the 6 month trial as Sensio is already having a visible impact on the number of falls people have:
One gentleman who stayed at Elmhurst for a total of 6 months, both before and after we implemented Sensio, had 12 falls during that whole period but while we were trialling Sensio in the last 2 months of his stay, he only fell once. When he first came, we set a lot of alerts for him and the Sensio team queried whether we needed them all. But over time we were able to reduce the number of alerts and we feel certain that it was that proactive, responsive monitoring that made a difference to him.
We know that another lady who has stayed with us several times is likely to fall in corridors when she walks out of her bedroom independently. So on her last 2 stays we have set Sensio to alert staff when she gets up from her bed or chair, or when she leaves her room. We can then support her to walk when she needs it and she hasn't had any falls since.
'I'd recommend Sensio because it's so visual and user friendly' Ruth, our registered manager, says. 'There's scope for widening the system in future too. We have the option to add pull cords for bathrooms in bedrooms and in communal areas and there's also a carelink type service, where people can go home with the system after their stay with us. It helps us to be really responsive but also promote people's independence and prepare people for going back home, where they won't be checked on day and night.'
'It also gives us crucial insight for planning people's discharges from Elmhurst' Lizzie, head of care, adds. 'We were in a multi disciplinary team meeting recently and one of the team asked how often one gentleman was getting up at night, and whether he'd cope without overnight care. We checked his graphs and could reassure them that he wasn't getting up at night. This is information you just can't get with any other system. We also love how much less intrusive the alerts are. With Sensio there are no alarms ringing in the bedrooms, and rather than every single telephone in the building ringing, the alert goes directly to staff's devices, so there's much less disturbance for everyone in the building. And with staff assigned to alerts in the area they're working in they're closer to where they are needed.'
Head of Care Lizzie Coltman and Registered Manager, Ruth Holder
To find out more about Elmhurst and to self refer, click here.
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