Amid workforce shortages and increasing inpatient volumes, many hospitals are turning to virtual nursing programs that augment in-person care with remote support. Research has shown most virtual nurses are given a dedicated role in the care journey, typically admission/discharge, patient education, or medication reconciliation.
Programs have been shown to succeed when bedside nurses play a role in program development prior to implementation and build relationships with virtual nursing teams. It’s also helpful to avoid duplicative workflows and maintain safe patient-to-nurse staffing ratios even when virtual nursing support is available.
These health systems are using virtual nursing to augment in-person care without creating additional administrative burdens or interrupting clinical workflows.
AdventHealth began with a pilot program in three Florida hospitals, with offsite registered nurses communicating to patients in the ED and inpatient units. One hospital reported a year-over-year drop in RN turnover from 46% to 16%. The health system is also piloting the use of virtual nurses to assist with inpatient admissions at one Colorado hospital.
Akron Children’s uses audio and video equipment to help employed RNs communicate with patients and families, as well as in-room sensors to monitor movement and alert nurses and necessary. Now live across inpatient units, the program builds on a pilot that reduced the time it took for ED orders to arrive in the unit.
Atrium Health assigns virtual nurses to about 10 patients at a time. Nurses monitor safety, assist with charting, and help with admission and discharge. Additional benefits include virtual nursing’s potential to provide emotional support to patients otherwise alone in the hospital room and allow older staff to mentor new hires without needing to be at the bedside.
BayCare began using virtual nurses to monitor ICU patients more than a decade ago. The program recently added virtual nursing at discharge, as the health system found most nurses spent 3 hours per shift on admission, discharge, and patient education tasks. Many nurses divide their time between virtual and bedside shifts – and say it helps them better focus on their work.
Boston Children’s found “virtual nurses provided a critical experience lens,” looking at charts, analyzing data, and otherwise offering procedural support while bedside nurses engage with patients and their families. The program ramped up in 2022 as the hospital hired nurses to meet demand for a new 150-bed facility.
Central Maine Healthcare has similarly focused on using virtual nursing to support staff with less bedside experience. By gathering medical history and other key information as patients transition from the ED to the floor, virtual nurses give bedside nurses the space to build relationships with admitted patients.
Covenant Medical Center served as the virtual nursing pilot for Providence. The model delivered quick results, reducing RN’s first-year turnover rates by 73%. Two keys to success: Virtual nurses take part in daily meetings alongside charge nurses, case managers, and physicians, and support teams remain in place to provide bedside support so floor nurses can focus on assessment.
Emory Healthcare complements employed virtual RNs to handle “hands-off care activities” with LIDAR technology to monitor patients for unexpected movements, proactive alerts of potential fall risks for bedside care teams, and automated voice messages to tell patients to remain in their beds until staff arrive. Eight inpatient units are part of the LIDAR pilot.
Houston Methodist is also building “self-aware” hospital rooms to monitor patient movement (and staff hand hygiene compliance). The hospital’s main focus, though, is virtual nursing for stroke care and psychiatric care, with the former leveraging neurologists from designated stroke centers and the latter using contracted providers.
Lee Health started with virtual observation supported by telehealth carts in acute care and ED settings. The hospital also invested in its staff – virtual observers transitioned from part-time to full-time status – which made it possible to apply virtual nursing support to all patients. Following implementation, the hospital saw a 20% improvement in HCAHPS scores.
Sentara Health virtual nurses provide support to more than 1,700 beds across 73 units. The emphasis is primarily on completing administrative tasks, though patient education – both at discharge and throughout the inpatient stay – has been a bright spot, as virtual nurses tend to have more time to answer patients’ questions.
Upstate University Hospital takes a unique approach, as patients use personal devices to connect to virtual nursing services over a secure network. The model may be different, but results to date have been the same: Nearly 2 hours saved per virtual admission and 44 minutes saved per virtual discharge, along with triage support and remote monitoring of vitals.
Vanderbilt Health started in cardiac care before deploying virtual nursing to inpatient units. Since the pilot, the health system made virtual nursing part of its new virtual care department, which leadership hopes “will enable virtual nursing to develop as a unit and work to meet the growing needs of the patients it cares for.”
Yale New Haven Health is another system that started with telestroke and TeleICU more than a decade ago and saw virtual nursing as a way to provide “vital support” for medical and surgical nursing teams. For example, bedside nurses have more time to address social drivers of health and connect patients to community resources they may need.
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