Real World Evidence (RWE) Evaluation of Cost Savings through Continuous Vital Sign Monitoring in the Medical-Surgical Ward: A National Health Service (NHS) Experience

OBJECTIVES: This study used RWE from the Chelsea and Westminster Hospital NHS Foundation Trust (CWFT) to estimate the cost-savings from continuous vital sign monitoring in NHS medical-surgical wards (“wards”).

METHODS: A model to estimate cost-savings for patients receiving continuous vs. intermittent vital sign monitoring (SpO2, pulse rate, respiratory rate) in wards was recently published using US data and adapted for this study¹. 2022 RWE extracted from CWFT electronic medical records was used as model inputs including: annual ward discharges = 24,000; average length of stay (ALOS) in ward patients without ICU stay = 7.7 days; ALOS in ward prior to ICU transfer = 8.5 days; ALOS in ICU after transfer from ward = 6.2 days; ICU transfer rate = 2.18%; Rapid Response Team (RRT) events per 1,000 discharges = 371; In-Hospital Cardiac Arrest (IHCA) per 1,000 discharges = 4.66; ward cost/day = 333£; ICU cost/day = 2730£; RRT Cost = 234£; IHCA Cost = 203£. Analysis modeled 50% and 100% adoption rate of continuous monitoring technologies across the ward.

RESULTS: Potential annual cost-savings for ward stays were estimated at £4,611,803 and £9,223,605 for a 50% and 100% adoption rate, respectively. The largest contribution to cost-savings came from reduced ward ALOS for patients not transferred to the ICU. Additional cost-savings derived from reductions in ICU ALOS, IHCA, and RRT activation.

CONCLUSIONS: Despite efforts at quality improvement, the impact of patient deterioration remains global and constant, demonstrating continued need to improve early detection. There is potential for cost-savings of over £9.2 million GBP per year for CWFT by improving patient outcomes through implementation of continuous monitoring technology in the wards. Health systems with longer ALOS and higher complication rates may experience additional economic benefits of this technology.