The reality show Undercover Boss gives the head of a major company the opportunity to experience work as an employee in their organisation. The result is that the leader benefits from the experience and know-how of hands-on staff.

In healthcare, important lessons can be learnt from patient-facing staff. Tan Tock Seng Hospital is implementing new systems and processes from the suggestions and feedback of nurses. These include greater use of AI, thermal imaging, and new inventions for improved safety.

Nurses from the hospital share how these innovations are preventing accidents, making sure patients don’t harm themselves by exiting a bed, for example. They also share how self-managed care can connect the hospital to the community.

Using sensors to monitor patient safety 

One innovation that was developed from nurse feedback was the use of sensors and thermal cameras to prevent patients injuring themselves leaving their bed. This technology reduces injuries among patients with very high fall risk or patients who are hesitant to ask for assistance.

Patient beds are monitored using a wall mounted thermal camera, with AI that monitors movement. When the AI detects that a patient is going to leave their bed, it sends an alert to nurses who can then assist and ensure safety.

The AI can accurately identify specific bed-exit movements with 99.7 per cent accuracy, says Assistant Director of Nursing, Chen Li. The on-duty nurses can also rely on the technology rather than physically patrolling, cutting manpower hours by 67 per cent, she adds.

Another use of sensors is the bedside alarm system that monitors the sounds coming from medical devices in the patient’s room. Once a device sounds an alarm, the sensors will trigger a notification for medical staff to follow up on the issue, explains Li.

The bedside alarm is still in prototype stage, but will be used in isolation wards. It will ensure that isolated patients are monitored while reducing the need for staff to regularly enter their room, she highlights.

The hospital has also deployed wearable sensors to monitor patient vitals, including heart rate and oxygen saturation. This reduces the need for sensors to be inserted into patient’s bodies, meaning less worry of infection, Li says.

The sensors allow nurses to focus efforts on urgent medical issues that require attention from staff, she explains. Healthcare staff can improve their time management as a result of this, Li points out.

Connecting the community and the home 

Tan Tock Seng Hospital has been developing new ways of connecting the hospital to the home.

One example is a mobile application that allows patients with cardiac conditions to undergo remote rehabilitation, doctors told Govinsider.

But what do nurses think about this change? The development of telehealth and remote care has shown that patients are capable of “self-managed” care, says Ng Woei Kian, Senior Nurse Manager Assistant Director of Nursing, Community Health.

Hospitals can “empower” patients by educating them on the “red flags” to look out for with their condition, she explains. Patients can keep track of their own health, and will not let their condition worsen to the point where emergency care is required, continues Ng.

Studies have shown that using telehealth to monitor patients with chronic diseases reduces emergency department admissions, she states. With smartphones and health applications being more common, these technologies can be enablers for greater remote care, Ng emphasises.

Reducing the amount of “siloed” information “helps us with better coordination of care”, she says. Using centralised data systems like the National Electronic Health Record system, patients, community clinics, and hospitals can share real-time information, Ng highlights.

Little inventions with a big impact 

Nurse feedback has also led to new instruments being adopted in the hospital. Previously, hospital staff used a simple container to collect equipment like needles and disposable items. Nurses identified that cluttered containers posed the risk of needle-stick injury.

A workgroup consisting of doctors, nurses, and housekeeping staff came together to create an innovative new design. Sharp objects are now kept in a clearly labelled separate section of the container, says Nancy Ang, Assistant Director of Nursing, Nursing Service.

The nursing staff also identified the need to easily coordinate the “many things” at a patient’s bedside. They helped develop a specialised tray to hold medication cups in place, making it easier for nurses to multi-task and communicate with patients, explains Ang.

“To retain nurses in the workforce, we endeavour to invest” in their development, says Dr Hoi Shu Yin, Chief Nurse. “We hope to inspire every TTSH nurse to be an evidence-based practitioner, an innovator, a leader and an educator in their roles”, she adds.

While we should be skeptical about taking lessons from reality shows, the premise behind Undercover Boss is worth considering. As shown with these nurse-led innovations, organisations can learn from the feedback and experience of its hands-on staff.

Image from Tan Tock Seng Hospital Facebook page