By the end of October 2025, Norfolk, Va.-based Sentara Health plans to implement virtual nursing across all of its 12 hospitals, supporting nearly 1,800 medical-surgical and intermediate care beds.
The health system chose a centralized model to enhance agility, protect patient privacy and better support bedside teams — part of a broader effort to redesign traditional care delivery amid ongoing workforce shortages and rising demands for healthcare services.
Becker’s recently caught up with Amber Price, DNP, MSN, RN, to learn more about Sentera’s virtual nursing expansion, her thoughts on the need for CMS to modernize its policies and lessons from the health system’s team-based primary care model.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Sentara recently said that it plans to implement virtual nursing across all of its 12 hospitals by the end of October. The health system selected a model in which the virtual nursing team will work from a centralized location. Can you shed some light on the decisions that led Sentara to choose this centralized model?
Amber Price: The main driver for the decision to centralize our virtual nursing team is agility. We want our team to be able to solve problems in the same space real-time, and work closely with our leaders to pivot if we need to quickly move in a new direction. The hallmark of our collaborative nursing culture is shared governance, which will be more challenging if these new teams are working from separate locations. We have learned a lot from our pioneer virtual nurses, and have adapted the process to suit our workflow. A top priority is to protect the privacy of the patient, which we can currently monitor from a central location. Building layers of patient protection is an ongoing process as we expand virtual care.
Q: What’s an issue or trend in nursing you’re following that you think deserves more attention — what should health system leaders be paying more attention to ensure a strong workforce into the future?
AP: Care delivery redesign should be a top priority. Our care teams are still structured in a traditional way, while the way we care for patients has dramatically shifted. CMS regulations have not adopted the new technology available. For example, we are still required to use in-person sitters for certain patient populations, when we already have a virtual solution. We are behind the technology, and need to do a full assessment of the workflow of the nurse in a modern tech environment, with virtual sitting and virtual nursing, smart beds and even scribing. The goal is to eliminate an inefficient workflow and improve patient safety. I think technology, to include AI, is a game changer for nursing, but that means we have to pivot and change the way we work in a modern care environment. We are utilizing an established governance structure to evaluate the best use of AI, championing the advancement of predictive analytics to stop barriers for our clinical teams way before it reaches the bedside.
Q: Sentara is transitioning to a team-based primary care model, significantly expanding the role of advanced practice providers to increase access. How has this shift affected nursing teams, particularly in coordinating care between APPs, physicians, and other members of the care team? What lessons have leaders learned about integrating APPs in a way that enhances patient care while supporting both physicians and nurses?
AP: By empowering nurses and APPs to care for the patient as part of a collaborative team, and by respecting and encouraging their full scope, we not only create efficiencies, but we add a 70% increase in capacity per APP. We have already launched nurse-led clinics in the outpatient setting that manage anticoagulation and hypertension with phenomenal success. We plan to add diabetes and behavioral health this year.
While we have built this as a team approach, with one physician leading multiple team members, the intent is to be able to solve problems together, rather than rely on the physician to be the ultimate decision maker in all cases. For nurse-led clinics, the relationship is between the RN and the pharmacist, for example, with escalation to an APP first if there is a clinical need to be seen. In this model, everyone works top of scope, and everyone has a safety net they can quickly deploy. It has had a positive impact, with nurses reporting satisfaction in developing a relationship with their patients, establishing continuity of care and taking personal ownership of outcomes.
Q: Flexible scheduling has emerged as a key factor in nurse retention and job satisfaction. How is Sentara Health adapting to the growing demand for flexible work arrangements while ensuring continuity and quality of patient care? — What types of initiatives have been most feasible here?
AP: We are currently going through a job standardization exercise, aligning jobs at each of our 12 hospitals and in every care setting across the system. We are acutely aware of the demand for flexibility and hybrid positions. Offering virtual nursing positions, and other non-bedside roles for highly skilled clinicians and specialists, allows us to provide more flexible hours that do not disrupt continuity of care and opens the door for working from or near home in the future. We are rapidly beginning to understand that these positions also open opportunities previously not available to those with physical limitations that restricted their ability to provide bedside care. I see virtual care expanding into the patient’s home, beyond our current virtual support offerings. Being able to engage the entire nursing workforce will help us recruit and retain nurses, and continuously expand new, and increasingly flexible, opportunities.
