Topic: Staffing

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. 

Disrupting the Nursing Shortage: Meet the “Virtual Nurse”

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

KLAS Recognizes 2022 Emerging Healthcare Solutions Top 20

“With staffing being one of the biggest issues for operations today, AvaSure makes a lot of sense because it is a force multiplier. Rather than having one sitter watch one patient, a unit can have one sitter watch twelve patients with remote monitoring.”
—Non-customer C-level/executive

This report includes the top 20 emerging solutions that have the greatest potential to disrupt the healthcare market ranked by healthcare leaders across the country

Healthcare executives are overwhelmed by the flood of new technologies in healthcare and can miss an amazing new technology partner because they are lost in the crowd. To solve this problem, KLAS has pulled together a group of provider thought leaders from around the country to help KLAS select the Top 20 Emerging Solutions that are disrupting the healthcare market.

In addition to rating the emerging solutions, our provider thought leaders also gave their input on technology innovation that address the quadruple aim of healthcare; Improve Care and Outcomes, Reduce the Cost of Care, Improve Patient Experience, and Improve Provider Satisfaction.

Read the press release and the KLAS news release to learn more. 

Virtual Nursing Emerged as Solution to Workforce Shortage in Texas During Pandemic Surges

On July 30th, 2020, as hospitalizations from COVID-19 were hitting new peaks across the country, Memorial Hermann Health System initiated a pilot virtual nursing program at 3 of its hospitals in Texas during its COVID-19 hospitalization surge.

ICUs at Memorial Hermann have large windows that allow nurses to monitor and check-in on patients without physically entering the room. As patients filled hospital beds outside these ICU locations, nurses had to physically enter rooms in full personal protective equipment (PPE) to periodically check in on the critically ill.

The program utilized mobile monitoring devices in rooms so nurses could monitor patients virtually, and soon the virtual program covered 14 ICUs during the summer surge through September. The program was designed to maximize shift efficiency, protect staff and patients from COVID exposure, and centralize protocols based on nursing qualifications.

As the COVID-19 delta variant spread, experienced critical care nurses were sent to a central video monitoring station that managed the health system’s 100 mobile monitoring devices, which allowed communication between less experienced staff to effectively monitor and care for COVID patients in the 2 subsequent surges that followed.

The system also allowed nurses at Memorial Hermann to safely and effectively monitor up to 8 patients from remote (at-home) locations if needed.

Memorial Hermann’s protocols included revamping its staff and nurse practices to accommodate for the high demand created by COVID-19 hospitalization surges and ongoing workforce shortages.

“We also in the future could use [the virtual program] for nurses who may not be physically able to work more than 3 shifts,” said Director of Hospital Information Systems at Memorial Hermann Scott Shaver, MSN and registered nurse. “I have full disclosure, I guarantee you if I was a nurse on the floor right now, I would do 3 shifts and that would be it. I am too old to do more than that.

My body doesn’t work that way [anymore]. But I can guarantee you that I can do 3 shifts in the ER and then do a shift at home using this. I could definitely do that. And so we actually have that availability as well not just for COVID but for really anything in the future. This can be applied to really anything that we can think of in the future where we can use virtual nursing to take care of patients.”

The company AvaSure provided the virtual nursing platform used by Memorial Hermann. The company sells evidence-based virtual care solutions, an innovative set of software and hardware aimed at inpatient telehealth care and utilized in nearly 1,000 hospitals across North America.

Juliet Aninye, a VA North Texas Health Care System nurse and LVN Lead for AvaSure’s TeleSitter® Program, was the winner of the Department of Veterans Affairs (VA) 2022 Secretary’s Award for Excellence in Nursing and Advancement of Nursing Programs.

The AvaSure TeleSitter® solution allows one trained hospital employee to monitor up to 16 patients simultaneously, preventing not only falls but elopement, violence against caregivers, and other adverse events.

“The bedside nurse will select which patients are most at risk for some kind of adverse events,” said Lisbeth Votruba, Chief Clinical Innovation Officer at AvaSure and herself a registered nurse. “[Falling] is a very common one. A frail elderly person who’s disoriented in a hospital setting—if they fall it can be really catastrophic. Those types of patients or a traumatic brain injury patient who’s impulsive and aggressive … or a patient who is in isolation with COVID, is delirious, their oxygen level is dropping, they’ve got to keep a mask on and they keep pulling it off. [It is important] to have the ability to monitor those higher risk patients, which is about 10% of the [in-patient] setting.”

Votruba said the virtual nursing models that have emerged improve efficiencies in patient admission and discharge, virtual preceptor mentoring, and critical care support that leverages nursing expertise across a health system in a centralized manner.

AvaSure’s video platforms that enable physicians and other clinicians to have instant telehealth check-ins with patients and their families are part of a $12 billion global telehealth market that exploded in growth during the pandemic.

Texas plans to invest $600 million over the next several years to expand broadband statewide and improve telehealth access for the 2nd largest rural population in the US. Nearly 2.8 million Texas households, or 7 million people, lack broadband access, according to the US Census Bureau.

According to the Texas Rural Health Association and Rural Health Hub, there are 64 counties in the state without a hospital, 25 counties without a physician, and 75% of counties are designated as Health Professional Shortage Areas (HPSA).

Virtual nursing advocates say the shortage of trained health care professionals in rural areas was an existing problem that was exacerbated by the pandemic and highlighted the state’s current health care system’s inability to reach these vulnerable communities.

The University of Texas Medical Branch (UTMB) School of Nursing will be launching a nursing certificate program in January of 2023 that aims to improve care for patients in rural areas where there are not enough professionals to care for these communities.

“For telehealth to be a widely adopted solution across Texas, providers need resources, education, and support to eliminate barriers and successfully implement telehealth tools into modern health care practice,” said Dr. Kristen Starnes-Ott, Vice Dean for Academic Affairs and Professor at UTMB School of Nursing.

She pointed out that many health care institutions shifted to a telehealth model as an emergency measure when the pandemic began, but much of it was done without adequate training.

With proper preparation, training, and implementation, she said that telehealth has great potential to help Texans receive needed care in areas with a shortage of providers.

Source: Boram, K (August 1, 2022). “Virtual nurse emerged as solution workforce shortage in Texas during pandemic surges”. State of Reform Texas

A New Approach To Staffing Crisis in Healthcare

Leaders of AvaSure, the pioneer of continuous virtual monitoring, and Equum, an innovator in critical care telehealth services, as they discuss the worsening nurse staffing shortage and how the companies’ new partnership can be a big part of easing the crisis. Lisbeth Votruba, MSN, RN, AvaSure’s chief clinical innovation officer, will cover the technology part of the solution, which will use the company’s hardware and software, already in more than 900 clinical settings in the U.S. and Canada. Corey Scurlock, MD, MBA, the CEO of Equum, will discuss how his company will use that technology to provide hosted monitoring and clinical services from its new Care Collaboration Center in Nashville. Equum already provides virtual care to many of the nation’s leading health systems, hospitals and post-acute facilities. Together, these experts in acute care telehealth will offer a bold new approach to addressing what has become healthcare’s most pressing problem.

Learning Objective: This webinar will provide insights into the top challenges in patient satisfaction and safety, nurse staffing and patient flow efficiency that hybrid models of care such as virtual monitoring provides.

AvaSure, Equum Medical Team Up on Telehealth Solution for the Nursing and Care Quality Crisis

NEW YORK and GRAND RAPIDS, Mich., Feb. 22, 2022 /PRNewswire/ — AvaSure®, the inventor of the TeleSitter® solution and the market leader in patient safety monitoring, and Equum Medical, a leading telehealth-enabled acute care professional clinical services company, today announced a new strategic partnership to help hospitals address the nurse staffing shortage and slow a sharp spike in adverse events in inpatient care.

Read the full press release to learn more.

AvaSure Recognizes OHSU Hospital’s Megan Fitzsimmons for Measuring Success and Upholding Effective Use of Technology

 

BELMONT, Mich. – AvaSure, a leading provider of advanced audiovisual monitoring systems used to care for patients and protect caregivers, honored Megan Fitzsimmons from Oregon Health and Science University Hospital with the Super Star Monitor Staff Member Award as part of AvaPrize, its prestigious annual healthcare awards program

The AvaPrize program honors individuals and organizations who have advanced patient and staff safety, eased the working lives of nurses and achieved new efficiencies in care delivery. Winners demonstrate the ever-evolving role of continuous video monitoring as it becomes a vital tool in patient care and staff development throughout a healthcare organization.

Fitzsimmons’ honor, the Super Star Monitor Staff Member Award, recognizes an individual who consistently goes above and beyond to help measure success and uphold effective use of the AvaSure TeleSitter.

“Most experts believe the post-pandemic U.S. healthcare system will be fundamentally different, as downward pressure on costs and a need to show value for dollars spent will fuel widespread reforms,” said Lisbeth Votruba, Vice President of Clinical Quality and Innovation at AvaSure. “Megan has played a significant role in making strides toward change with the use of our technology. As has been shown in numerous clinical and economic studies, AvaSure is in tune with the need for cost-effective, quality care.”

AvaSure selected Fitzsimmons for the award because of her work as one of the first to deliver a mobile device to a unit at Oregon Health and Science University Hospital. She has helped shape the program into what it is today and led a survey with data demonstrating how valuable the monitoring technicians are to patient families.

The winners were honored during the company’s symposium Sept. 23-24. The AvaSure national symposium brings together senior leaders, frontline staff and health policy experts to share best practices and new uses for continuous remote patient care. This year’s theme was Leading Through Change.