• Matt Morris

ROI - Digital Rounding for Q15s & safety checks


What is the true cost of an adverse safety event at a psychiatric hospital or addiction treatment center? How can you measure the return on investment (ROI) of preventing an event that can involve injury, loss of life, litigation, diminished reputation, and more? How can you reduce the risk of such events without breaking the bank (and maybe even increase revenue in the process)?


When a patient harms themself or elopes, there is an obvious human cost to the patient(s) involved. There is trauma to staff, which can affect morale and retention. Other patients may even require more care because of the emotional aftermath of the event. This human cost is hard to measure, but the financial cost is not.


Depending on their severity, adverse patient events can incur multiple costs, including the following:

  1. Time and cost for staff to conduct an internal review

  2. Time and cost of external investigation and creating and implementing plans of correction

  3. Impacts on survey and the potential for citation

  4. Litigation costs

  5. Higher liability insurance rates

  6. Time and cost of recruiting and training new staff (due to staff attrition)

  7. Loss of facility reputation, referrals, and the ability to fill beds.


High Risk vs. Low Risk?

Some facilities have reduced their risk and have annual safety costs only in the thousands of dollars, while other facilities have more regular safety events -- experiencing losses exceeding one million dollars for a single event. So where does this difference in risk come from? The director of a state psychiatric hospital stated it well: “Nine times out of ten, when there is an incident, there is some failure with observations.” An analysis of CMS safety incident data will reach a similar conclusion.


A 100-bed psychiatric hospital conducts around 9,600 patient safety checks (Q15's) per day. With paper tracking of safety checks, it is almost impossible to know if these observations are being done correctly, or even being done at all. Most of the time, this is not a problem, but when an adverse event occurs, suddenly those piles of paper in the back room become critical but also overwhelming to sort through. And who knows if the data they contain is accurate? In our experience, fully compliant Q15 checks happen only two-thirds or less of the time, which means that some of that paper data may be completely false.



Lack of compliant safety checks can be due to the ethos of an entire care team, or simply the fact that on every unit there are both high- and low-performing staff. With proper checks happening only about two-thirds of the time, it is clearly a gamble as to which health tech will be on duty when an event occurs. Will it be the tech who comes around the corner at the right interval -- in time to prevent the harm? Or will it be the tech who is still at the nurse’s station while a patient elopes or harms him or herself or others? When facilities implement VisibleHand’s digital rounding system, compliance rates increase to 100% within days, so it is much more likely that your staff will be on the spot when needed, thus making critical -- and expensive -- safety incidents much less likely.


Digital Rounding

An electronic safety rounding system requires more initial investment than does a pile of paper and pencils, but the payoff comes in two ways -- reducing costs and raising revenue. First, the costs. Given that sentinel events are expensive and those incidents usually arise from inadequate safety checks, anything that improves the quality of those checks will ultimately reduce the cost of an event. But an easy-to-use electronic rounding system can also reduce costs on an ordinary day. Because rounds can be completed more quickly and with less oversight, staffing levels can be reduced without any loss of efficacy. As one addiction treatment program manager put it: “This really cut down on our tracking time. It increased our work productivity where I can do more with less people.” The ability to track individual staff performance can incentivize high performers and improve their retention while allowing managers to coach low performers, or even fire them with legal justification: to “coach up or coach out,” as one unit manager puts it. This will raise the overall quality and efficiency of the unit and the facility as a whole. Additionally, costs of paper management will be reduced, and data will be easily obtainable to support both external and internal audits, allowing fewer staff to do more.


The increased efficiency and quality of care resulting from the use of an easy-to-use digital rounding system doesn’t just reduce costs, but it also provides the opportunity to improve patient outcomes and even increase revenue. The data that is collected by our electronic rounding system has helped facilities gain certification to take on higher acuity residents, which, in turn, can lead to faster expansion of facilities, higher occupancy of existing beds, and, ultimately, higher reimbursements.

Of course our primary goal is quality patient care - it is why we exist. But we also want to do this at the lowest possible cost. Our product improves patient outcomes while reducing costs and providing the opportunity to increase revenue. To learn more, visit visiblehand.com.

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