Managing Eating Disorders on a Generalized Peds Unit: A CVM Pilot

Managing Eating Disorders on a General Pediatrics Unit: A Centralized Video Monitoring Pilot
Shadman KA, Coller RJ, Smith W, et al. J Hospital Med. 2019;14(6):375-360.

Challenge

While supervision is generally considered an essential element of caring for hospitalized patients with eating disorders, it is costly, reduces staff availability for the care of other patients, and can be a barrier for patients.

Best practices for patient supervision often include mealtime or continuous 1:1 supervision by nursing assistants or other staff and has been shown to prevent unwanted behaviors and facilitate weight gain leading to earlier discharge. However, best practices to overcome cost and resource availability have not been established.

Solution

Centralized video monitoring (CVM) may provide an additional mode of supervision for patients with eating disorders.This study compared the use of CVM with the AvaSure TeleSitter® solution with that of 1:1 nursing assistant supervision.

• Median cost for supervision via CVM was significantly less—$1166/admission for CVM vs $4104/admission with a nursing assistant
• Length of stay was reduced by 2 days with the use of CMV—9.8 days (mean) vs 11.7 days with nursing assistant supervision
• Days to weight gain were comparable between the 2 approaches: 3.1 days (mean) with the nursing assistant and 3.6 days with CVM

Conclusions

Although this study was small and was not powered to detect potential differences or to adjust for all potential confounders (such as other mental health conditions or comorbidities, eating disorder type, previous hospitalizations), these results show that CVM offers significant opportunity to supervise patients with eating disorders in a more cost-efficient manner, without compromising on outcomes.