After early success with its hybrid virtual nursing model, Cleveland-based University Hospitals is expanding the program to two emergency departments and an entire hospital.
Less than a year ago, the health system introduced a model whereby nurses can work a hybrid schedule, spending several days bedside and the remainder of their schedule in a remote care hub as a virtual nurse. Now, leaders are working to outfit two emergency departments and an entire hospital facility to support virtual care, a move they anticipate will enable more integrated, team-based care.
“Our hypothesis is that we can expand the services and roles when all of the units within a hospital are wired with the virtual care capacity,” Jennifer Carpenter, DNP, RN, chief nursing informatics officer at the health system, told Becker’s. “This allows us to move beyond nursing to include providers, consultants, families, as well as remote patient observers. Some patients need additional caregiver eyes on them at all times, and the ability for an observer to use the audio and visual connection will provide safety for more patients in a new way.”
The system has already integrated transitional care coordinators and outpatient nurses into the platform, with additional roles expected as the program moves into emergency departments.
University Hospitals decided to scale the hybrid virtual nursing model after leaders saw improvements in patient and caregiver engagement scores in the initial five units, Dr. Carpenter said. Initially, patients were much less hesitant about virtual care than leaders had anticipated —many found it comforting to interact virtually with nurses they had already established rapport with during bedside care, she said. The approach has also been a way to deliver on nurses’ growing demands for flexible scheduling, without sacrificing care continuity or team cohesion.
Looking ahead, University Hospitals is monitoring the model’s effect on safety events, such as falls, caregiver turnover and retention, and whether it contributes to reduction in contract labor utilization over time.
While 74% of hospitals indicate virtual care is or will become integral to their care delivery models, there’s no single virtual nursing approach that works best. Health systems nationwide are exploring a wide range of models — from fully remote hubs to command-center staffing. Leaders are balancing costs, infrastructure and workforce goals and looking to peers for shared lessons.
“Health systems all have slightly different approaches to this work, which creates expectations by some leaders that other ways are better or preferred,” Dr. Carpenter said. “I don’t think there’s a ‘right’ or ‘wrong’ way, but that’s why it’s so important to align on your priorities and success criteria.”
