AdventHealth leans into virtual nursing

Reducing workload for bedside nurses can play a crucial role in retaining these workers and ensuring they are able to provide optimum patient care. That is the premise of AdventHealth adding virtual nurses at its hospitals.  

The Altamonte Springs, Fla.-based health system, which has 39,000 team members in Central Florida, began piloting the program in April at its Fish Memorial hospital in Orange City. The health system has also been piloting the program in inpatient units at its hospitals in Daytona Beach, DeLand, Ocala and, most recently, Orlando. The 37-bed emergency department at Fish Memorial is the only ED piloting the program. 

"What prompted it was looking at where we were with the workforce, and really looking at the burnout factor with nursing coming off of the heels of the pandemic, and really looking at how we can reduce the workload intensity for our bedside nurses. What can we do to retain our nurses at the bedside?" Michele Johnson, MSN, RN, chief nursing officer for Fish Memorial, told Becker's.

How it works

Under the program, bedside nurses partner with virtual nurses to ensure completion of certain tasks. Patients who approve the virtual nurse component have access to a registered nurse working off-site, via a webcam in their room. 

Ms. Johnson said the virtual nurses may help with tasks that don't require someone at the bedside, such as general admission data forms or medication reconciliation, which allows more time for bedside nurses to focus on high-acuity patients.

This approach has allowed AdventHealth to reduce turnover at campuses. In the Deland hospital units where the health system has piloted virtual nurses, monthly nursing turnover has declined to less than 1 percent. Since launching the pilot, as well as several other workforce recruitment and retention initiatives, Deland has also significantly reduced patient length of stay and agency use, according to AdventHealth. Nursing turnover in the Fish Memorial ED has declined from nearly 39 percent to 8.1 percent because of virtual nurses and other recruitment and retention initiatives. 

"We found that our nurses were able to spend more time with their patients, No. 1," said John Lazarus, emergency department director of Fish Memorial. "No. 2, they had more time to document the care they were providing to their patients. The third thing we also discovered is that the patients in the virtual nursing rooms use their call lights less often."

Mr. Lazarus said during observation of the pilot, hospital leaders also found that bedside nurses were more apt to take full breaks during the assignment with a virtual nurse. Meanwhile, the AdventHealth Research Institute is also working to quantify and qualify the impact the virtual nursing program is having on burnout. That research effort is ongoing.

"Our nurses have told us that they find it very beneficial, [and] our patients are telling us that they appreciate the additional information that they're getting from the virtual nurse," Mr. Lazarus said. "Because they introduce themselves, they let them know exactly what's to be expected, get their history, get their medication reconciliation."

Still, Ms. Johnson acknowledged there have been some technology challenges during the initial piloting. 

"It's not all perfect," she said. There have been "some limitations with some of the technology with camera downtime and some things with that. But it was really having the close partnership with the vendor that we chose to work with and the facilities themselves … [that] helped to make sure it was a success."  

Future plans

Moving forward, AdventHealth is eyeing potential plans to expand the virtual nursing program to more facilities. 

Ms. Johnson said she also views the program as a future pipeline for some more senior nurses who want to be a virtual nurse. 

"Somebody who is more advanced in their career could maybe use this as another opportunity for their career," instead of retiring, she said.

More information about the program is available here

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