137-Bed Long-Term Acute Care Hospital (Anonymous Study Site)

The hospital struggled to reduce inpatient falls while controlling high costs associated with one-to-one sitters. There was limited long-term peer-reviewed evidence demonstrating both quality and financial outcomes from virtual sitting programs specifically in LTACH settings. The organization needed to evaluate whether virtual monitoring could sustainably replace expensive 1:1 sitter staffing without compromising patient safety.

The hospital deployed a continuous video monitoring (virtual sitting) program using AvaSure's platform across a 137-bed LTACH over a 40-month study period (20 months baseline, 20 months intervention). Virtual sitters were actively managed — assigned, reassigned, and discontinued based on patient need — avoiding passive monitoring. Sitter-to-patient ratios were optimized over time, increasing from 1:10 in the first 9 months to 1:12 in the final 11 months.

The program achieved a statistically significant 25% reduction in patient falls (p=0.02) and a 90% reduction in 1:1 sitter hours (p<0.001). Total measurable financial impact reached $3.2M over the study period, comprising $160,234 in direct sitter cost savings and $3,041,390 in avoided fall-related costs. Notably, the higher 1:12 monitoring ratio delivered superior safety and financial outcomes compared to the earlier 1:10 ratio.

• Intentional, active management of virtual sitter assignments (not passive monitoring) is essential to achieving sustained fall reductions and cost savings.
• Higher sitter-to-patient ratios (1:12 vs 1:10) can deliver better outcomes, challenging the assumption that lower ratios are always safer or more effective.
• Virtual sitting in LTACH settings benefits from extended patient stays that allow virtual sitters to learn patient behaviors and enable more proactive monitoring strategies.