Hackensack Meridian Health has made a conscious effort to identify ways to streamline administrative tasks for its bedside teams, minimizing non-clinical burdens for frontline staff. That's why the New Jersey health system decided to enhance its nursing staff with a virtual nursing program.
The work of virtual nursing staff decreases the documentation currently completed by bedside nurses and allows for increased direct care interaction. Through virtual nursing, the health system can expand care delivery while ensuring nurses are empowered, supported and able to focus on what matters most – patient care.
Early results show virtual nursing supports faster discharging procedures, coordinated care planning and optimization of in-unit nursing time through the shifting of the documentation burden.
A partner in care
Virtual nursing provides the on-site team with a partner in care, integrating remote, real-time nursing support into existing care teams, said Regina Foley, RN, executive vice president, interim president central region, chief nurse executive, and chief transformation and integration officer at Hackensack Meridian Health.
"The virtual nursing program proposed a model where virtual nurses could assist on-site clinical teams by performing non-clinical tasks and providing additional resources for patient monitoring and discharge support," she continued. "By sharing these responsibilities with virtual nurses, our bedside nurses can focus more on high-acuity care, thereby reducing their administrative workload and increasing satisfaction.
"Pre-implementation, we worked with telemedicine company Equum Medical and AvaSure to design a program that could scale across different units and integrate seamlessly with our existing hospital systems," she added. "We envisioned this as a way to improve the overall efficiency of our clinical staff."
With virtual nurses working remotely, clinical teams could continue to receive timely assistance, access educational resources and streamline communication, all of which are critical in meeting the growing needs of the patient population.
Driving virtual nursing at scale
Virtual nursing at Hackensack Meridian Health is different because out of the gate the health system committed at the executive level to drive virtual nursing at scale.
"The program will be further implemented across several clinical units in support of expedited patient progression and capacity management," Foley explained. "Virtual nurses will be integrated with the local care teams and can assist with tasks such as monitoring patient vital signs and discharge planning.
"These tasks will be supported through real-time video consultations and, in the future, AI-driven decision support tools, which can help ensure accurate and efficient communication between virtual nurses and bedside staff," she continued.
The virtual nurses are highly trained registered nurses who work remotely and are directly integrated into the hospitals' clinical workflow through systems like the electronic health record and patient monitoring platforms.
Change management is key
"The clinical workflow design aspect integral to the Equum Medical model of implementation focuses on change management, and the key steps to ensure we are able to successfully launch and sustain the program," Foley noted. "The integration with AvaSure's technology-enabled virtual nurses to assist in decision making and predictive analytics will also support our bedside teams.
"Our future goal is to see metrics associated with increased team member retention and reduced vacancy rates," she continued. "While early on in our journey, nurses have expressed they are able to focus on more critical tasks and direct patient care, while virtual nurses handle the routine monitoring and documentation tasks."
At full implementation, the health system hopes to see a reduction in patient discharge times and increased patient throughput across units with virtual nursing. And in the future it hopes to measure patient experience scores. Early evidence suggests patients are appreciating the more personalized support they receive and their overall hospital experience.
For organizations considering virtual nursing, Foley advises starting with a clear understanding of goals and how this technology can align with existing infrastructure.
Making a careful choice for technology
"Your technology choice also needs to be designed for the future and integrates well with your current clinical systems, such as your EHR and patient monitoring tools, so virtual nurses can work seamlessly with your on-site teams," she said. "Equally crucial is providing education for the virtual nurses to become aligned with the culture of your organization, as well as training and ongoing support for the bedside team, so they are equipped to work together effectively.
"Another piece of advice is to focus on change management – introducing virtual nursing technology will impact workflows, and it's important to have a plan in place to address any concerns," she continued. "Engage your clinical teams early in the process, keep lines of communication open, and be prepared to adopt lessons learned from your implementation. The key to success lies in ensuring that virtual nursing is seen not as a replacement but as an enhancement to existing care models."
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Email him: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.
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