If you read healthcare news, or even if you don’t, it would be difficult to miss the widespread coverage like this story in The Guardian about Cox Medical Center Branson in Missouri and its implementation of "panic buttons" for hospital staff.
As the hospital’s Facebook page declared in September 2021, "Assaults on our staff by patients have TRIPLED in the past year. Tripled."
The company’s move is yet another proactive example of a response to increasing violence against healthcare workers, especially during COVID-19.
"It’s something that we worry about every day," Idaho Department of Health and Welfare Director Dave Jeppesen told the Associated Press in September. The news agency reported that animosity from patients and community members statewide had resulted in physical violence and verbal abuse against healthcare workers.
The problem is global. As early as February 2021, The UC Berkeley Human Rights Center and Insecurity Insight "documented more than 1,100 attacks and threats of violence against healthcare, including medical personnel, patients, healthcare facilities, and transport. Some 400 of these attacks appear to be specifically COVID-19 related."
This type of technology to keep staff safe and to prevent minor issues from becoming major—and if they do, enabling staff to sound the alarm for "Help!"—is not new. It’s just that their use has increased more recently, says Stephanie Bertschy, senior marketing manager for Midmark RTLS. Midmark RTLS is based in Michigan, and is part of the larger Midmark Corporation, which has 12 domestic locations and as well as offices in India and Italy.
Midmark’s button is featured in the photo from the above story—RTLS stands for "real time locating system." Cox Medical Center South trialed the technology and took it facility-wide, and now it’s being expanded to Cox Branson, says Midmark RTLS Product Marketing Manager Jeanne Kraimer.
Options for Healthcare Staff Safety
Panic buttons, also called staff duress alarms or staff assist buttons, aren’t the only ways to enhance safety and security, says the International Association for Healthcare Security and Safety Foundation. Other modalities include:
- Video surveillance: cameras and sound detection
- Access control: keycard, touchpads, and/or biometrics—fingerprints, facial patterns, voice
- Body cameras
- Mass notification systems
"I do think panic buttons or duress alarms are a great tool," says Eric Clay, MSc, CHPA, CP, PCI, vice president of security at Memorial Hermann Health System in Houston and a member of the Board of Directors for the International Association for Healthcare Security & Safety. "They’re merely one of many tools that can be part of a strategy, a comprehensive security plan, to help mitigate violence. Companies are going to have to invest in more security so employees feel safe and protected."
He estimates "dozens of companies" may offer viable security options. With so many choices available, Clay advises hospitals, health systems, and others to work closely with their security teams to better understand what works best for them before diving into decision-making about which product to purchase.
Along the way, it’s important to collect and analyze data, then look for opportunities to prevent efforts from occurring in the future. "De-escalation techniques should be a part of that strategy, too," he says.
Emergency departments, and often behavioral health units—especially those dealing with the opioid epidemic—were early adopters of the buttons, and continue to be supportive of their use, says Bertschy. "Then COVID added another layer of frustration, especially when patients couldn’t have visitors," she says.
They’re not just for the ED, however. Pinpoint Inc.’s healthcare staff duress systems are also used in urgent care, and in billing departments, as well as in maternity wards, says the company’s Healthcare Safety Specialist Corey Greenberg—indications, he says, that bad behavior is no longer confined to emergency care.
"Times have changed, and it takes a lot to shock me," he says. "For example, it seems there’s too much family drama occurring in certain areas like the maternity ward. My passion is designing a system for the client, going back to them later, and seeing their violence numbers go down."
Greenberg says the Hauppauge, New York–based company has completed more than 3,000 installs worldwide.
‘A Much Louder Cry for Help’
The systems’ increasing popularity is not surprising, since the U.S. Occupational Safety & Health Administration (OSHA) says "a hospital is one of the most hazardous places to work." The Bureau of Labor Statistics says, "Healthcare workers accounted for 73 percent of all nonfatal workplace injuries and illnesses due to violence in 2018."
Installing a system "shows a healthcare system’s commitment to keeping their staff safe," says Chris Sampson, MD, FACEP, and president of the Missouri College of Emergency Physicians.
"I think staff think these buttons provide an additional way to alert others when they are in danger," he says. "There are times in the ED when staff are alone with a patient or family member and encounter a potentially dangerous situation where they need additional help."
He said he’s personally seen the staff duress buttons used in situations where a nurse was able to receive assistance and avoid a potential situation where physical harm could have come to them.
"The button gives a much louder cry for help than just using one’s voice and enables many people to respond with aid," Sampson says.
"Our team is extremely grateful for this added layer of protection as incidents of workplace continue to increase in healthcare settings," says Lynne Yaggy, vice president and chief nursing officer for Cox Medical Center Branson. "These buttons will allow security to arrive even faster, which brings our staff a sense of peace."
RTLS Has Multiple Applications
Bertschy estimates that perhaps 30 percent of hospitals and healthcare systems nationwide now use RTLS for many reasons, including asset tracking, nurse call automation, patient flow optimization, staff duress, and more, and says the company’s technology "is in hundreds of hospitals."
Midmark’s clients include recognizable names such as Johns Hopkins Medicine and Memorial Sloan Kettering as well as smaller community hospitals, oncology centers, and outpatient clinics across the United States.
For those still wondering whether they should invest in such a system, Kraimer points to a study published in the The Joint Commission Leading Practice Library and conducted by Trinitas Regional Medical Center in central New Jersey.
It found that, despite a 39 percent increase in assaults on Trinitas staff, "post-implementation" (of the RTLS system) results showed a 93.5 percent decrease in days lost from work, and an 89 percent decrease in the associated cost of lost wages.
The company’s own research has shown that among hospitals contacted, 53 percent are considering adding RTLS technology within the next two years, says Kraimer.
Midmark’s technology utilizes badges that are provided to staff, and wired or wireless sensors, which are installed throughout the building to receive signals.
"Most of our systems are hard-wired since this technology is usually spec’d when a new hospital is built," Kraimer says. "However, I wouldn’t downplay the wireless component because that’s easier for an existing hospital to implement, with sensors typically in the ceiling."
"The badges and sensors communicate to determine the locations of staff or equipment," Bertschy says. "RTLS can be used across many different departments and areas, leveraging the same system but using it for different applications."
The technology can also be used to track important assets like IV pumps or ventilators, improve patient flow, track patient movement, and inform about how long a patient has been waiting. It can convey when a nurse exits a patient room and then prompt the physician that it’s their turn to enter. RTLS can also provide location data to third-party systems, such as a nurse call system or electronic medical record.
Buttons Can Prevent ‘A Fire’
Greenberg explains that Pinpoint’s wearable technology, the emergency-calling, personal infrared transmitter badge (PIT), identifies the exact location and type of call in less than 85 milliseconds—it uses high-level, not direct-site, infrared, he says. It’s also antimicrobial and comes with an anti-ligature lanyard.
All of Pinpoint’s hardware is hardwired, he says, and the company’s transmitter may also be used as a 15-minute bed check and patient nurse call.
The buttons are "discreetly" contained in an ID card holder just like those used to enter a hospital unit by scanning employee credentials. It can be easily connected to work with cell phones, whether team members are on site or not, and with desktop PCs at a unit facility hub.
The system is in use at Mayo Clinic, Montefiore Medical Center, and Northwell Health, among others, Greenberg says.
The demand for these products may see even more usage this year. Clay notes that The Joint Commission’s new and revised workplace violence prevention requirements now applies to all of the commission’s accredited hospitals and critical access hospitals, as of January 1, 2022, prompted by the rising numbers of workplace violence incidents.
This article first appeared on Health eCareers. Reprinted with permission.