Virtual Nursing Shifts its Focus to the Patient Experience
By Eric Wicklund
As virtual nursing programs mature in health systems and hospitals across the country, some executives are envisioning a concierge care strategy.
Sharp HealthCare, for example, debuted its VIP platform roughly two months ago in the neuroscience unit in preparation for the opening of the new Sharp Grossmont Hospital for Neuroscience. This expanded co-caring model known as Vitual InPatient nursing services (VIP) leans heavily on patient engagement strategies, with the goal of having the virtual nurse as the patient’s guide through the healthcare journey.
Tracy Plume, Nurse Director for the San Diego-based health system, says the new model was co-designed by patient advisors, information technologists and front-line nurses.
“The patients really want to know that someone was behind the scenes monitoring their record, looking at their chart, that nothing was going missed,” she says. “They felt that that would make them feel safer, that their care was progressing as it should be. And that they had the opportunity to daily meet with the virtual nurses and ask those questions.”
“They get an extra connection with the nurse, a healthcare provider, someone on the care team, to help coordinate that admission to discharge process.” Plume adds.
Plume and Susan Stone, Sharp HealthCare’s SVP of Health System Operations and System Chief Nursing Executive, recently took part in HealthLeaders’ Virtual Nursing Mastermind program. Executives from roughly a dozen health systems met virtually and at an in-person event in Atlanta to discuss how their programs are evolving, where they see challenges, and how this strategy will evolve.
For Sharp HealthCare, virtual nursing is more about care delivery transformation, or crafting a new strategy for inpatient care that involves all the members of the care team. The idea took root in 2023 after a board member witnessed how Providence (another Mastermind participant) was transforming its care team strategy. Stone says she and her colleague spent a year researching the concept and looked at roughly 20 virtual nursing programs across the country.
Roughly one year ago, on April 1, 2024, Sharp launched its first virtual nursing program in two selected units, focusing primarily on handling admissions from the Emergency Department and discharges. The program has now spread to all four of Sharp’s hospitals, encompassing about 600 licensed beds and 16.2 FTEs and running seven days a week, 12 hours a day.
Stone says the program focused on admissions and discharges first because those were the key pain points identified by frontline nurses who were included in the planning process. Sharp built is ROI strategy, she says, on reducing those time-consuming processes, thereby improving patient throughput and freeing up beds faster for new patients (Stone says the health system is runs between 85-95% capacity, making available inpatient beds a valuable commodity).
“We’re still working hard on producing and defending the return on investment,” she says.
Other factors include readmissions (a costly pain point for every health system), nurse workflows and well-being, and patient satisfaction and engagement.
And that’s where version 2.0, the so-called VIP experience, comes in. Stone and Plume say Sharp leadership wanted to target the patient experience in the evolution of virtual nursing, with a service that creates a care program around the patient.
“We’ve really taken our program past services and alleviating that administrative burden on the nurse to really being more part of the care team,” Plume said.
Plume says the patient experience should always begin “with a warm hug,” a feeling that the patient is being cared for by a team, both in the hospital room and behind the scenes. Through the virtual portal, a nurse is keeping an eye on the patient’s healthcare data, coordinating with other members of the care team and the patient’s family, handling administrative duties and funneling education and other resources to the patient.
Whether this program can be expanded to all hospitals at Sharp depends on ROI, which will take time to develop. Stone notes that patient satisfaction rates have soared since the program’s inception soaring, a good sign that they’re more engaged with the care team and understanding their care at home management plan.
In addition, Stone says discharges are much more timely, and when recently speaking with frontline nurses, they report being able to facilitate patient discharged by 11:30 whereas before it would have been into the late afternoon to facilitate three discharges by themselves.
They are now looking at the possibility of folding other services into the virtual nursing platform, including deterioration alerts, sepsis alerts and the potential to be more efficient with virtual sitting throughout the system. Others have suggested adding virtual visits by specialists, such as diabetes educators.
“To us the future is for all different types of virtual care, and we know that other smart programs will be deployed via the electronic health record system, and we haven’t really launched them to their fullest extent,” Stone says.
“All of those things are business cases that we need to take one at a time,” she adds. “We don’t want to go too fast too soon because that could set the program up for failure.”
Eric Wicklund is the associate content manager and senior editor for Innovation at HealthLeaders.