'Cognitive offload': Why MultiCare is expanding virtual nursing to 9 hospitals

Tacoma, Wash.-based MultiCare Health System has started a virtual nursing pilot and plans to roll out the technology to eight more hospitals by the first quarter of 2024, nursing leaders told Becker's.

The health system launched the program in May at MultiCare Deaconess Hospital in Spokane, Wash. The plan is to have it at 500 beds across the organization by the end of March.

MultiCare developed the initiative after holding more than 50 listening sessions with roughly 1,000 nurses.

"The demand is going to increase with the baby boomers. The nursing shortage is going to get worse. And our primary care nursing model isn't sustainable. So how do we redesign our care model?" said June Altaras, MSN, RN, executive vice president and chief quality, safety and nursing officer at MultiCare. "In addition to that, we've heard these big themes around: 'I want to be treated as a knowledge professional. I feel like I'm a factory worker with tasks, tasks, tasks.'"

MultiCare had found that nurses spent about a third of each 12-hour shift on things other than patient care, including documentation and delivering supplies.

"How do you give RNs cognitive offload?" Ms. Altaras asked. "That's where the virtual nurse comes in for us."

The new care model also includes Moxi robots that help transport supplies, medications and lab samples. The 12-hospital system also adopted Epic's Rover app for mobile charting and documentation.

The virtual nurses help with admission, discharges, medication reconciliation and skin checks, reducing the demand for in-person registered nurses. They are employed by IT company Banyan Medical and based in the Midwest. They also chat with in-person nurses throughout the day in a secure chat area in Epic.

"They're available to mentor. They're available for questions. They're watching vital signs," said Donna Woelfel, MSN, RN, vice president and chief nursing information officer of MultiCare. They're really looking at that patient's chart that they're assigned to to make sure there's anything that needs to be done." 

MultiCare visited Birmingham, Ala.-based Baptist Health to learn how the health system has expanded virtual nursing beyond its medical-surgical units.

So far the virtual nurses at MultiCare have been well-received. Several patients have asked, "Can I take the virtual nurse home with me?" Ms. Altaras said. (That may soon be possible as the health system looks to expand into hospital-at-home and remote patient monitoring.)

"The patients love them," she said. "They show up on the TV. Even if you're my mom who's 92 and has Alzheimer's. My mom could not operate an iPad or cell phone. But she can turn the TV off and on."

Ms. Altaras is also hopeful that virtual nursing will allow the health system to retain older nurses who can't physically handle three 12-hour shifts at the bedside anymore.

"It will become a way to retain knowledge and wisdom and experience. Nurses won't have to retire as soon," she said.

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