Pre-Lung Transplant Waitlist Mortality Rate Reduction Using Remote Video Monitoring Technology

Abstract

Purpose Lung transplant (LTx) candidates often have multiple medical comorbidities along with end stage lung disease. As their lung disease progresses, they experience increased symptom burden and increasing hypoxia and oxygen requirements, increasing the risk of delirium. This poses an increased safety risk, especially if they become disconnected from their supplemental oxygen supply. The use of remote video monitoring (RVM) has been shown to improve safety and prevent adverse events in various hospitalized patient populations. However, it has not been previously evaluated for the pre-LTx patient population. Our objective was to investigate the feasibility of RVM in this population. Methods We conducted a feasibility pilot from 07-2016 to 12-2017. Rapidly deteriorating pre-LTx patients that were admitted to hospital and requiring high flow oxygen support were observed with RVM. Consent was obtained from all patients and/or family. Mortality rate and adverse event incident reports were assessed prior to and post implementation of RVM. A satisfaction survey was also administered to patients, family and healthcare providers. Results Fifty-three consecutive patients admitted to hospital while on the LTx waitlist were included in the pilot. The average length of time monitored was 136 hours (range 18 - 715). The mortality rate of LTx candidates was reduced from 21% to 6% post implementation of RVM. Reporting of adverse events causing severe patient harm was also reduced. Overall, patients, families and healthcare providers provided positive feedback on the reassurance and overall performance provided of the RVM program. Conclusion Our findings suggest that RVM in hospitalized end stage lung disease patients listed for LTx is feasible and enhances patient safety and satisfaction.