Researchers at the Dartmouth-Hitchcock Medical Center (DHMC; Lebanon, NH, USA) implemented a PSS system in a 36-bed orthopedic unit with 10,938 patient days and 3,207 patient discharges per year. The PSS included wireless communications connecting bedside oximetry monitors to a server computer and a radio transmitter, which notified nurses via a pager when preset physiological limits were violated. Intensive care unit (ICU) transfers, length of stay (LOS), mortality, and financial costs were available for 2007, as well as after installation of the system in 2008. Using this data, a decision tree model was applied to evaluate the cost-effectiveness of the system for the hospital.

The researchers found that implementation of the PSS decreased average LOS from 3.6 to 3.4 days; decreased ICU transfers per 1,000 patient days from 5.2 to 2.7, and decreased the average LOS of those who transferred to ICU from 7.67 to 5.87 days. Mortality risk also decreased from 0.47% to 0.39% per patient. The subsequent financial analysis calculated a cost savings per patient of $255 per patient for the implementation year, and projects that savings should be $404 for subsequent years. Sensitivity analysis showed that cost-effectiveness was driven mainly by the reduction in ICU transfers. The study was presented at the International Anesthesia Research Society (IARS) annual meeting, held during March 2010 in Honolulu (HI, USA).

"Current standard of care for hospital inpatients is the sampling of intermittent vital signs and clinical examinations, with additional monitoring for patients considered to be at high risk for adverse events,” concluded senior author Andreas Taenzer, M.D., and colleagues of the department of anesthesiology. "PSS can potentially improve outcomes and save costs. These findings could aid hospital administrators and physician leadership in their decision to deploy patient surveillance systems.”

For the study, the researchers used the Masimo Patient SafetyNet remote monitoring and clinician notification system with Masimo signal extraction technology (SET) pulse oximetry, both products of Masimo (Irvine, CA, USA).

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Dartmouth-Hitchcock Medical Center
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