Topic: Nurse Leadership

AvaSure Introduces Virtual Classroom Webinar Series on Virtual Nursing

Hosted by Chief Clinical Officer Lisbeth Votruba, series will detail how nursing leaders can launch and implement virtual nursing programs

BELMONT, Mich., March 21, 2023 /PRNewswire/ — AvaSure, the inventor of the TeleSitter® solution and the market leader in acute virtual care and remote safety monitoring, announced today that it will kick off a virtual classroom series on March 23, “Virtual Nursing 101,” which will detail how nursing leaders can launch and implement virtual nursing programs.

The virtual classroom series is hosted by AvaSure Chief Clinical Officer Lisbeth Votruba, MSN, RN, who will be joined by special guests and experts to cover pressing industry topics, such as the role of the virtual nurse and how to build a virtual nursing business case, as well as lessons learned from ongoing programs.

“Nursing leaders across the nation understand the numerous benefits that virtual nursing could deliver to their health systems but often have questions about how to get started and what it takes to create a successful virtual nursing program,” said Votruba. “We are delighted to launch this series to help spread awareness of how virtual nursing represents a new model of care that can help health systems improve patient safety, reduce labor costs, and protect staff from caregiver violence, while reducing documentation burden on staff and increasing staff satisfaction.”

Votruba is a pioneering nurse executive committed to continuous improvement of healthcare and the diffusion of new technologies to drive patient and staff safety. She is a member of the Medical Surgical Nursing Certification Board (MSNCB) Virtual Nursing Job Analysis Task Force as a subject matter expert for the creation of a medical-surgical virtual nurse certification, and for nearly 15 years, she has worked extensively with over 1,000 hospitals in standing up their virtual care platforms.

The free, six-part series will take place on the last Thursday of each month and feature Votruba along with special guests and experts. The first session, scheduled for March 23 at 12 p.m. EST, will feature Terri Hinkley, EdD, MBA, BScN, RN, CAE, CEO of Academy of Medical-Surgical Nurses.

In this session, Votruba and Hinkley will discuss the role of the virtual nurse and what was involved in the creation of the MSNCB Professional Certification, the competencies to look for when hiring virtual nurses, and how to recruit for the role without exacerbating existing staffing challenges.

Virtual Nurse Webinar Schedule

March 23: The Role of The Virtual Nurse

April 27: Introducing The Clinical Resource TeleNurse Model: What Is It And How Can It Help?

May 25: Building A Virtual Nursing Business Case

June 22: Introducing The Expert Oversight TeleNurse Model: What Is It And How Can It Help?

July 27: Selecting The Right Technology Partner For Virtual Nursing

August 24: Starting & Scaling Your Virtual Nurse Program

To learn more about “Virtual Nursing 101” and register to attend, click here.

About AvaSure
AvaSure provides the leading hospital virtual care platform to systems with nursing and staffing shortages that are challenged to significantly reduce labor costs without sacrificing patient health outcomes. Recently recognized by KLAS Research as the leader in reducing the cost of patient care, AvaSure is the pioneer in providing best-in-class, video-based AvaSure TeleSitter® and TeleNurse™ solutions. As a trusted partner of more than 1000 hospitals, AvaSure combines remote patient monitors, virtual nurses and other providers on a single platform to enhance clinical care without placing any additional burdens on existing staff. To learn more about AvaSure visit www.avasure.com.

Media Contact:
Marcia Rhodes
Amendola Communications
mrhodes@acmarketingpr.com

Success Stories – How to Retain and Recruit Virtual Safety Attendants

Discover the latest tips and tricks on how to recruit and retain virtual safety attendants. Our panel of experts, Tiffany Villamin at VA North Texas, Lori Colineri at Hackensack Meridian Health, and Lisbeth Votruba at AvaSure share their insights and answer questions in this video on the best ways to deal with high turnover rates among monitor staff.

Virtual Nursing – It’s a Thing, But Where to Start?

A few years ago, it was estimated that by 2030 the U.S. would experience a shortfall of more than half a million nurses, with a huge loss in quality and availability of care.

The pandemic sped up the timeline.

The greatest concern was the potential loss of specialized expertise; two-thirds of 6,000 critical care nurses surveyed in August 2021 said they were considering leaving the field from burnout.

Solutions have been hard to find, but Houston’s Memorial Hermann Health System has tried something new:

  • As the COVID-19 delta variant spread, critical care nurses were detailed to an existing central video monitoring facility. There, these “virtual nurses” can care for COVID-19 patients across the system, supporting less experienced bedside nurses and improving patient quality and safety.

Key learning objectives of this on-demand webinar:

  • Discover the basics of virtual care, including the technology and the art of video and audio interactions with patients and bedside staff
  • Learn about policies and workflows Memorial Hermann established for virtual nursing
  • Find out how virtual nurses can make the highest use of specialized care resources

Presenters:

  • Scott Shaver, MSN, LP, RN, CPHIMS, Director of Hospital Information Systems, Memorial Hermann
  • Mary Ellen Carrillo, MSN, MBA, RN, CVRN, FABC, Chief Nursing Officer, Vice President of Nursing, Memorial Hermann
  • Jennifer McGuire, Manager, Staffing, Memorial Hermann
  • Lisbeth Votruba, MSN, RN, Chief Clinical Innovation Officer, AvaSure

Tackling the Nurse Staffing Crisis with Virtual Care Models: Best Practices from Corewell Health and AvaSure

According to Lisbeth Votruba, RN, Chief Clinical Officer AvaSure, recent studies show that 80 percent of hospitals are interested in virtual monitoring or virtual nursing, yet only 2 percent have fully implemented such programs.

At the Becker’s Hospital Review 7th Annual Health IT + Digital Health + RCM Annual Meeting, in a workshop sponsored by AvaSure, two healthcare leaders — Ms. Votruba and Matt Barr, Senior Clinical Systems architect at Corewell Health in Grand Rapids, Mich. — discussed innovative deployments of virtual care technology.


Three key takeaways were:

When deploying virtual care solutions, clinical and IT teams must work together closely. 
In 2018, nurse leaders at Spectrum Health begin to investigate whether virtual safety monitoring was superior to traditional one-to-one sitters for adult and pediatric inpatients. Clinical evidence supported the expanded use of virtual safety monitoring and the clinical team selected AvaSure as their preferred solution.At this point, the IT team got involved and raised questions related to scalability, security and more. “Because IT challenged clinical on their choice and did its own, redundant investigation, the duration of conception-to-go-live took 18 months. Much longer than it needed to be.” Mr. Barr said. Today, walls between clinical and IT have been broken down and the two teams have a more collaborative relationship.

Virtual patient monitoring is financially attractive and protects patients from harm. 
At the newly merged Beaumont Health Spectrum Health (BHSH System – now Corewell Health) monitoring staff serve as lifeguards for 12 to 16 patients at a time. “This is a great entry-level healthcare position,” Ms. Votruba said. If issues arise, such as a fall risk or signs of potential harm, the monitoring staff’s first action is to verbally engage with the patient. In an emergent situation, they can use an alarm to bring staff to the bedside. “Over the last rolling 12 months, Corewell Health has documented 53,000 near misses on falls,” Ms. Votruba noted. In addition, with volatile and potentially violent patients, remote sitters help keep staff out of harm’s way.Organizations have also used the AvaSure TeleSitter® Solution for “out of the box” applications, like conversing with lonely, elderly patients or monitoring pediatric patients for non-accidental trauma from family members.From a financial perspective, the return on investment associated with AvaSure is easy to demonstrate. Over 12 months, Corewell Health provided 660,000 hours of virtual patient monitoring at $2.39 per hour for the technology and FTEs to monitor it. Providing one-to-one sitters for the same hours would have cost $10 million, assuming sitters are paid $16 per hour.

Virtual care models are a promising solution for closing the experience gap among newly hired nurses. 
Not only are healthcare organizations grappling with nursing shortages, but those nurses currently in the job market are often less experienced. This is a challenge since many patients today have more complex conditions and behavioral health issues are on the rise in acute care settings.To address these issues, Corewell Health will be running a virtual nursing pilot. “Experienced nurses who were thinking about leaving the workforce have been recruited for this program,” Ms. Votruba said. “They will take virtual nurse roles, providing mentoring and support to novice nurses on the floor. The remote expert virtual nurses will also handle some admission and discharge documentation, as well as patient education that requires an RN license.” One virtual nurse and two novice nurses will cover 10 patients. Outcomes data will be collected related to patient flow, dismissal times and nurse turnover. “The evidence suggests that with this model, dismissal times can be shortened by 30 minutes,” Ms. Votruba said.

Looking ahead, the Corewell Health team is optimistic about virtual care and other technology solutions. “COVID changed everything and virtual became the norm,” Mr. Barr said. “One positive is that we brought IT and clinical leaders together and they learned to make decisions quickly. Trust has developed across the board.”

Firman, J., Cook, J., Bass, T., & Forrester, S., “Implementing a Virtualized Care Model for Inpatient Nursing”, American Organization for Nuring Leadership 2022 Conference, April, 2022.

Read the full article here. 

Transforming the Industry: Day 2 of the AvaSure Virtual Symposium 2022

After an energizing first day, we’re back with another afternoon of fantastic content to share with you. As Gerry Lewis said during our closing fireside chat, in today’s environment clinicians and IT teams have a responsibility to work together to, “Create an end-to-end ecosystem that leverages enhanced clinical process and integrations, so we aren’t overburdening our clinical staff from a cognitive and burnout standpoint – otherwise, we are going to be challenged to take care of those in need in our communities.” Our role in helping to provide elevated patient care while liberating the bedside nurse has never been more important than in the midst of current staffing crisis.  

Today, we focused on Change Agents: Creating Awareness, Confidence and Excitement when rolling out a new care model inclusive of AvaSure TeleSitter and TeleNurse programs. We discussed obstacles to overcome, best practices for implementation and keys ways to share results with leadership. Then, we spoke with systems that have scaled to hub and spoke model systems – increasing their coverage through a centralized monitoring model. Ending the day, AvaSure CEO Adam McMullin sat down with Gerry Lewis, former CIO/EVP of Ascension to discuss the role of technology in the future of healthcare – exploring how to drive change at a health system, advice for expanding your virtual care program and how clinical leaders can best partner with their IT teams.   

Let’s look at some of the key findings from today: 

Change Agents: Creating Awareness, Confidence and Excitement

Presenters:

  • Shannon Robertson, BSN, RN, Unit Director, Virtual Care Operations, Carilion Clinic Park View
  • Jason Crouch, Virtual Care Operations Manager, Carilion Clinic Park View
  • Meg Alexander-Patton, RN, BSN, Carilion Clinic Park View
    • No one is going to be a bigger advocate for your program than you are! You need to sell the value of your program – to leadership, to staff – for it to be successful. Meet with teams at all levels, explain the service and benefits to drive utilization. 
    • Change doesn’t end – it’s constant. If you don’t keep yourself on the front of people’s mind, they may forget you. Keep pushing to find new and innovative ways for devices to be used to continue pushing value of the program higher. 
    • Trust is the biggest key to success. Leadership and bedside staff need to trust that the monitor staff isn’t just “watching a camera” but adding value. You can demonstrate this with great catches, with shadowing programs and with communication.  
    • Listen to your staff – try to understand potential pain points, make them feel heard and important. Also make sure stakeholders have skin in the game, including these stakeholders in the process helps drive the best outcomes ensuring they have reasons to help drive the program forward. 
    • Best practice: do shadowing as part of interview process so that monitor techs can truly get a feel for what their job will be like before accepting the role, this helps them grasp the reality of the role and drive retention 

Centralized Monitoring: Optimizing Labor Across an Entire Health System 

Presenters:

  • Mark Quirin, MSN, RN, Regional Manager for Virtual Monitoring Loyola Medicine
  • Katherine Mitchell, BS, BSN, RN, CMU/VMU Nurse Manager, Baptist Health Medicine
  • Kahlia King, CARE, Assistant Nurse Manager, Cox Health
    • Think about time zones being served and having an adequate hiring pool when picking a hub location.
    • As best you can, standardize data collection and routines across spokes being served by your hub to ensure consistency 
    • Involve more stakeholders up front – think beyond just clinical teams when starting your program and include case management, social work, security, financial leadership and more 
    • Consider a steering committee to help drive policy and procedure implementation but also to have people not in the “day to day” provide a wide-angle lens on your program 

Best practices for creating an engaged and effective monitor staff: 

  • Consider flexibility in scheduling – 12-hour shifts may make sense for nursing but not for monitor techs sitting at a desk, consider breaking them down or allowing for regular breaks to ensure they’re engaged when monitoring 
  • Use sit-to-stand desks to give monitors a way to change up their workspace. Want to take it one step further? One panelist has treadmill desks, stationary bikes and more! 
  • If you’re in an office environment, consider ‘theme days’ – like potlucks, pajama days, karaoke parties and more! 
  • Focus on recognition: use a ‘wow wall’, kudos system, newsletters, or emails to share great catches and recognize your monitor staff 

Fireside Chat with Gerry Lewis, Former CIO/EVP of Ascension and Adam McMullin, CEO AvaSure: How Technology Plays a Role in the Future of Healthcare 

  • Three things to consider when trying to drive change at a health system (if you can meet 2-3 of these, we should be taking next steps in how we operationalize this):
    • Does this differentiate the patient or clinical experience? 
    • Does this help us improve the value of the services we provide? Can we provide better services and be more efficient in how we deploy them? 
    • Is there an opportunity to bend the cost curve? 
  • The key to project success: clinically led but technically enabled – if that partnership isn’t there it’s very difficult
    • When working together with clinicians and IT teams – the more we create relationship and trust, break big complex processes down and continuously iterate we will be more successful. We like to go after these big bang projects where we expect everything to be perfect instead of starting with the first 20% and iterating until we feel like we’ve met all the clinical needs
  • We are at an inflection point; skilled care labor shortages have put us there. We need to look at how we apply labor and technology differently. We need to look at models, processes, technology and people in a very different way because the fundamentals are going to be challenged. 

Thank you to all who joined us for an exciting two days of sharing stories, learnings and experiences together.  

Transforming the Industry: Day 1 of the AvaSure Virtual Symposium 2022

We had a fantastic first day of the AvaSure Virtual Symposium focused on Transforming the Industry. “This year, our customers are focused on protecting their patients, making things easier on their care teams and reducing cost”, per Adam McMullin, CEO of AvaSure. That’s why the theme of this year’s event is Transforming the Industry. We know that customers need to make changes to their care delivery model in light of macro factors and we are here to help.  

Day one’s discussion were focused on various aspects of this care model transition – starting with Virtual Nursing: It’s a Thing, But Where to Start? We then spoke with a customer panel on using the TeleSitter solution to monitor for suicidal patients – an important and underutilized form of virtual monitoring. We ended the day highlighting the superstars of monitor staff programs sharing their best practices on staffing a program.   

Let’s look at some of the key learnings from today: 

Virtual Nursing: It’s a Thing, but Where to Start?

Presenters:

  • Sarah Brown MSN, RN, Chief Nursing Officer, UnityPoint Health
  • Amy Hassell MSN, RN, Director of Patient Services, UCHealth Virtual Health Center 
    • 89% of hospital and nurse leaders are moderately to extremely interested in virtual nursing, but most are still in planning phases. From our customers on the panel who have implemented, they all say, “just do it”. As our one panelist said, “have courage to try something – create some buzz around it. There’s a lot of work in this, but it’s good work so give it a shot.”  

Early results from virtual nursing pilot panelists:

  • Time savings for bedside staff using a TeleNurse for admission and discharge – reduce admission time by 12 minutes and discharge by 15-29 minutes 
  • Saw increase in patient experience scores on HCAHPS – 7.6% increase in patient understanding of purpose of taking medication and 2.04% increase in top box score for transition in care 
  • Critical care expert TeleNurse helped drive increase in rapid response calls and an unprecedented 25-70% reduction in code blues in combination with deterioration education 

Lesson learned for starting a virtual nursing program:

  • Whatever process you’re designing needs to make sense for and solve a need at the bedside. It needs to be easy for the end user, needs to be seamlessly integrated and make sense in building a team effort.  
  • Clarify what virtual nursing is – and importantly what it is not – to all team members 
  • Need senior leadership buy in but nurse managers and front-line staff buy in is essential – start conversations on the issues they’re having and key pain points to address 
  • Just jump in and be willing to iterate – you need to be flexible and be willing to adapt as you gain feedback. The hardest thing to do is just say go and start. 

Keeping Suicidal Patients Safe, Virtually

Panelists:

  • Debbie Cronin, RN, Director of Patient Care Services, St.Peter’s Health 
  • Kim Beckett, RN Manager – Clinical Surveillance, Ascension Michigan 
  • Wesley Wingate, Director Cardiac Telemetry, HCA Methodist
    • You may have to address your hospital policy, but virtual monitoring of low and moderate risk suicide ideation patients is accepted by most governing bodies 
    • If you’re struggling to gain buy in or are skeptical, consider a pilot where a physical sitter is outside the room with a virtual monitor. This will allow a safety net while you gather outcomes of how verbal interventions help prevent adverse events. This can be presented, in addition to research and testimonials, to leadership in order to drive program acceptance. 
    • Device selection is key based on your anticipated use cases. When purchasing devices, if you anticipate using on SI patients make sure you consider ligature risks and buy appropriately, or this can be a challenge down the road. 
    • Training and education of monitor staff here is key – AvaSure provides a great module focused specifically on suicidal patients that can help educate both monitor and front-line staff 
    • Best practice: don’t think about limiting just SI patients in a ratio for your monitor techs, instead make sure they take note of all “busy” patients (could be falls risks, elopement risks, SI or other risk) and ensure they don’t have more than 2 per monitor tech 

Tips, Tricks & Tales from Monitor Staff Superstars

Panelists:

  • Kearston Winder, Ascension Via Christi 
  • Juliet Aninye, LVN, VA North Texas Health Care System
    • It’s all about communication – communication with the patient and communication with the bedside staff. Ensure you properly introduce yourself and your role to the patient to put them at ease but also ensure there is easy, routine communication between monitor staff and the bedside team for an effective TeleSitting program. 
    • Develop a handoff process – some panelists used a document where monitor techs would note any key interventions or patient/nurse preferences that could be given to the next tech, but whatever your process ensure information can flow from nurse shift to nurse shift and monitor tech to monitor tech 
    • Best practice for veteran facilities: Many of these patients may suffer from PTSD. Ensure your staff when introducing themselves coaches on what a verbal intervention and stat alarm will sound like so they are not startled – especially when sleeping 
    • Best practice: have an escalation pathway on both sides – so that monitor staff know who to escalate to when they can’t reach the nurse and so nurses know who to escalate to when they have feedback for the monitor staff. It all comes down to transparency and good communication. 
    • Build rapport with the patient through conversation, this will help them to respond more positively during intervention periods  

For those who joined us – we hope you enjoyed the first day as much as we did. If you missed it, all of the recorded sessions will be available for viewing next week. Make sure you tune in tomorrow as we have another great day of content including:  

  • Change Agents: Creating Awareness, Confidence & Excitement! 
  • Centralized Monitoring: Optimizing Labor Across and Entire Health System 
  • Fireside Chat with Gerry Lewis

See you tomorrow! – AvaSure Team 

Oregon Study First to Look at Evidence-Based Expansion of TeleSitter Programs

There is a wealth of peer-reviewed research on AvaSure’s success in helping to reduce falls and sitter costs. Many hospitals that adopt the solution quickly see the financial and clinical payoffs, and look to expand the program. A lot of decisions need to be made, including how many rooms and/or units to cover, the challenges that need addressing, what hardware to employ and whether or not to have a single central monitoring hub or unit-based staff.

A new article in the Journal of Nursing Care Quality, centered on the experiences of Oregon Health & Science University (OHSU), explores the factors that can help clinical leaders make those choices more effectively.

After implementing AvaSure in 2018 with 10 mobile devices and three in-ceiling devices, OHSU was able to stabilize upward trends in sitter use in adult acute care. It quickly became clear that demand at OHSU would outstrip supply. A growing video monitoring waitlist and sitter utilization needs combined with staff shortages to create an urgency to getting certified nursing assistants off of sitter duty and back out on the unit, using AvaSure for every patient who met inclusion criteria.

The authors calculated that continuous virtual monitoring saved $2 million per year just on sitters. An average of 5,593 adverse events were prevented at OHSU per 1,000 patient-days in the past year.

OHSU used a variety of metrics to evaluate AvaSure program expansion, including high video monitoring utilization rates, sitter use demands, wait-list growth and national/local increases in behavioral health needs. “One of our most powerful metrics, however, is the subjective data related to staff perception of need,” the authors write. Acting on the need for expansion from a staff nurse perspective is an “imperative aspect of multilevel empowerment” at OHSU, a Magnet nursing organization.

The team success in writing an expansion initiative using those metrics added 13 mobile devices. A partner community hospital decided to leverage an opportunity to expand AvaSure into its facility for a total of 23 more room devices. As part of the expansion, OHSU is implementing a hub and spoke model with its partner.