Nursing executives at the nation’s largest rural health system, participating in the HealthLeaders Virtual Nursing Mastermind program, say that ‘extra set of eyes’ is a crucial component to inpatient virtual care.
Virtual nursing programs have seen early success in helping floor nurses reduce time spent in the EHR and doing other administrative tasks. But at Sanford Health, nursing leadership wanted a more interactive platform.
Erica DeBoer, SVP, CNO for the health system that spans 56 hospitals and seven states across the upper rural Midwest, says leadership was intent on using an audio-visual platform from the start, and using the virtual nurse to “be another set of eyes and ears”that nurses in the patient’s room might not notice.
That might include vital signs or pain reassessment that need to be checked haven’t been collected, or a medication that needs to be taken. It also might be a patient showing subtle signs of mental distress, or someone at risk of falling, or a tense situation between a patient and a nurse that needs backup.
“Can we prevent some escalation of patient behaviors,” DeBoer says, “[and] get additional help to the patient room to support our team on the floor?”
Erica DeBoer, SVP, Chief Nursing Officer for Sanford Health. Photo courtesy Sanford Health.
That’s not a concern unique to Sanford Health, but it does underscore the value of a virtual nursing platform in providing support to floor nurses. Since the COVID-19 pandemic, health systems and hospitals have been dealing with high rates of nurse stress and burnout and a declining workforce, and they’ve been putting a premium of technologies and processes that improve the nurse’s workload and attract new nurses.
“It’s a recruitment and retention tool, knowing that our workforce is looking for forward-looking organizations that leverage technology to support care and safety,” DeBoer notes.
For the nation’s largest rural health system, keeping and attracting nurses is critical. And that begins with supporting them at the bedside.
DeBoer says the program, which is expanding to 40 more beds and integrating technology through the in-room television, is staffed from within. Nurses can be scheduled for two shifts on the floor and one shift as the virtual nurse, so that both patients and floor nurses know who’s at the other end of the audio-video feed.
As a result, those virtual nurses are also well-attuned to the tasks of the floor nurse, and they’re more apt to spot something that needs to be done. Instead of waiting for the floor nurse to ask for help, they can offer help when they see that need. This shifts the focus of the virtual nurse from a task-oriented workflow to one of observation and support.
It also reduces the friction between floor and virtual nurse, DeBoer says, and facilitates a team-based approach to care.
Advocates say virtual nursing can help providers address another trend: Hospital patients are becoming sicker, and their hospital stays are becoming more complex. That’s putting even more pressure on nurses.
“It’s not uncommon for our patients to travel anywhere from 30 minutes to four hours to receive care in an inpatient setting.” DeBoer says. “By the time they need hospital care, they’re there for a reason. They’re acutely ill in many cases and need to be admitted and require care.”
And while virtual nursing will improve the inpatient experience, DeBoer sees a future outside the hospital as well. Rural health systems like Sanford rely on a network of sites and providers to span long distances and keep remote residents is small communities connected to care. With resources at a premium, that might mean using virtual nurses in skilled nursing and rehab facilities, maybe even the home.
“Our philosophy is that we have the technology, we have the platform, now how can we scale it?” DeBoer says. “Let’s try to see what’s going to work, knowing that a mile saved from being on the road means reduced time away from work, school and the comfort of their own homes.”
In rural communities, that also means expanding the platform to include more care providers, from doctors and specialists to social workers.
“We are focusing on nursing, but the technology doesn’t prevent us from having multiple individuals leverage it to help care for patients in new ways,” she adds.
DeBoer says there’s plenty of agreement among nurses and administration that virtual nursing will stay.
“Our teams are trusting us that this is what the future holds,” she says.
The HealthLeaders Mastermind series is an exclusive series of calls and events with healthcare executives. This Virtual Nursing Mastermind series features ideas, solutions, and insights into excelling your virtual nursing program. Please join the community at our LinkedIn page.
To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.
Eric Wicklund is the associate content manager and senior editor for Innovation at HealthLeaders.
KEY TAKEAWAYS
Sanford Health launched its virtual nursing program after the COVID-19 pandemic with both audio and visual capabilities, and is integrating those services into wall-mounted TVs in the patient’s room.
Leadership sees the platform as an important tool for floor nurses who not only need help with administrative tasks but an extra set of eyes on the patient.
Erica DeBoer, the health system's SVP and CNO, says they’re seeing benefits to patients and nurses that support sustainability.