How Trinity Health perfected the tech for virtual nursing

Livonia, Mich.-based Trinity Health now has virtual nursing in 19 hospitals across 10 states as it marches toward its goal of having the care model in 6,500 beds nationwide.

Along the way, the 101-hospital system has worked out some of the technological kinks — such as virtual-nurse call buttons and how to have enough TVs — to be able to expand the care model across the organization.

"With this being an innovative care delivery model, there's not a playbook out there on how to implement this model or how to connect the technology or how to connect your old call system to really be able to support the workflows of this model," Gay Landstrom, PhD, RN, senior vice president and chief nursing officer at Trinity Health, told Becker's. "We really had to create that and continually learn and deal with supply chain shortages. So we have learned a great deal."

As health systems increasingly turn to virtual nursing to relieve staffing shortages and improve the patient experience, Trinity Health is believed to be further along than any of its competitors. The organization plans to stretch virtual nursing across its footprint, covering about 6,500 beds and 17 more states, by mid-2026. The health system started piloting the model in 2022 before beginning to scale it about a year ago.

Trinity Health uses the same care model across all 1,623 beds and 50 units. A bedside registered nurse and nursing aide — either a licensed practical nurse, nurse assistant or certified nurse assistant — work in tandem with the virtual nurse to care for patients.

"They're consistently working all throughout their shift all throughout the day. It's these three people working together as a team to care for patients, and that's quite a different model from other organizations." Dr. Landstrom said.

The health system also now employs 280 virtual nurses, all with at least eight years of experience. They work out of hubs either inside or near the hospitals.

Benefits have included decreased turnover and employee engagement scores. The biggest challenge has been recruitment — even though the model aims to help with staffing shortages and burnout, it still requires registered nurses and aides, who can be in short supply. To that end, Trinity Health has started a development program for nursing assistants.

"There were also things we didn't even think about — things like TVs and the compatibility of TVs," said Murielle Beene, DNP, RN, senior vice president and chief health informatics officer at Trinity Health. "We were talking about, 'Oh goodness, this may stop our go-live because we don't have enough TVs.' Someone said, 'Well, can we just run to Best Buy to get them?' It was intended to be funny, but, no, this wasn't a Best Buy situation."

Trinity Health also had to reconfigure its nurse call buttons to add an option for patients to contact the virtual nurse. "They push a button and the virtual nurse comes on the TV screen and can talk with them immediately," Dr. Landstrom said. "It's just a very different process and it's so much faster and the patients love it."

Beyond call buttons, Trinity Health is looking for other technologies that can better loop in the patient, bedside and virtual nurses together, perhaps by implementing tools from Epic, Dr. Beene said. The health system also wants to add functionality to allow virtual nurses to provide dual verification on things like narcotics and blood products, as well as conduct video conferences with family members remotely.

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