Topic: Virtual Nursing

4 Key insights from AvaSure’s first digital summit

AvaSure Symposium ft. Lisbeth Votruba on stage

Last week AvaSure hosted our 1st Annual Digital Summit: Start, Scale & Succeed with Virtual Sitting. During this one-day educational event, we featured over 10 current AvaSure customers to share their best practices & learnings from deploying virtual sitting programs.  Read on to hear how they were able to improve outcomes, optimize their labor force and protect staff all while helping to reduce costs.

There were so many exceptional discussions centered around today’s challenges – staffing being front and center. We know that hospitals across the U.S. are struggling to find enough nurses and support staff to run efficiently, so technology is helping to bridge the gap. With the AvaSure TeleSitter® Solution, hospitals are replacing the need for traditional 1:1 sitters by using Virtual Safety Attendants (VSAs) to monitor up to 12 patients remotely while reducing adverse events. Seem too good to be true? The results just may be.

How Valley Health Reduced the Use of 1:1 Sitters While Decreasing Falls

Valley Health System shared their story of starting a TeleSitter program four years ago that has gone on to help:

  • Reduce falls with injury by 50%
  • Save over $1 million dollars from combined fall reduction and sitter cost reduction
  • Achieve an 80% device utilization across the system

When discussing why they chose to work with AvaSure, they said, “We wanted to work with the experts to show us how this has worked at other organizations. Other organizations have made mistakes, had those mistakes corrected and so we are the beneficiaries of that. We wanted to focus on what we are good at. What we aren’t good at is setting up our own sitter program. But, what we are good at is knowing our needs, selecting the best partner out there and picking someone who could address our needs today & help us go beyond that in the future.” AvaSure has helped over 1,000 customers just like Valley Health start their programs and we have the clinical expertise to help make it as turnkey as possible for your staff.

Use Cases for TeleSitter solutions extend beyond just falls

Success of virtual sitting extends beyond just the acute care setting, Gaylord Specialty Healthcare gave a sneak preview of yet-to-be published results of how AvaSure helped optimize their LTACH program.

While virtual sitting programs may be best known for helping reduce falls, their use extends far beyond that one use case. We heard from Rachel Krajnovich, MSN, RN-BC, Director of Clinical Operations at HCA Kingwood on utilizing virtual monitoring for suicide risk & behavioral health patients.

  • Suicide is the 12th leading cause of death in the U.S. across all age groups and the number of patients requiring suicide monitoring in acute care has increased 165% since 2019
  • 45% of hospitals that utilize AvaSure have monitored over 75,000 suicide risk patients across 45 states

This lesser-known use case can be extremely effective in helping to monitor low and moderate suicide risk patients, and is proven to be equally effective to in-person sitters for this population(1). These customers shared best practices regarding how they evaluate patients to be placed in the program, how they helped to get physicians and staff on board with utilizing virtual monitoring for this high-risk population and how it has helped them extend access of needed yet scarce mental health resources in ERs today.

Expanding to other use cases is just one example of scaling your program, you can also help to extend the reach of your program across various facilities in your system, helping you to achieve greater scale and efficiency. Providence Oregon Region shared how they built a ‘hub and spoke’ model – which involves having devices across multiple facilities with monitor staff at one, centralized hub watching patients across the system. This can help create a highly effective staff that is able to protect patients across the system and optimize your device utilization. Hear how they were able to achieve an average stat alarm response time of 12-15 seconds, well below the national average of 17 seconds.

Virtual Safety Attendants are Key to Program Success

 As always, one of our most popular sessions was best practices from Virtual Safety Attendants – sharing how they’ve built teams of heroes that work 24/7 to connect with patients, keep them safe, keep them calm & help assist them on their recovery journey. We heard from a VSA, Tom Dezell from Froedtert, who shared when thinking back on advice he’d give himself on his first day:

 “That I cannot let my fear of something happening to the patient interfere with my taking care of the patient. In other words, I can’t respond out of fear, I have to respond out of patient advocacy and confidence.”

His demonstrated commitment to his patients brought emotions to all who listened as he spoke so passionately and eloquently about the time he spends helping patients.


What Does the Future of Virtual Care Look Like?

We closed the day with Claire Zangerle, DNP, MBA, RN, NEA-BC, FAONL, FAAN, Nurse Executive with CMZ Strategies, LLC discussing the future of virtual care with AvaSure Chief Clinical Officer, Lisbeth Votruba, MSN, RN. In discussing her hopes for the future of nursing in this new virtual care environment she said,

“It’s our time as nurses to step up and make sure we’re listened to. We have to tell people how great it is to be a nurse and what it means to be a nurse. We’re in danger of people saying that the job is too hard to do. Everyone wants to work remote now, you can’t be hands on and work remote. You have to promote the value of human interaction, it’s so important. We know we don’t have enough staff and enough people to do human interaction whether it’s in a hospital, ASC, community health center, we know we don’t have enough people. We need to meet patients where they are, and we need to think of new ways to meet patients. We aren’t thinking about this because we don’t have enough staff, it’s also because that’s what patients want. We are looking at ways to make sure they get what they want.”

Nursing has always been and will always be an essential and noble profession that relies on hands-on patient care, clinical expertise & empathizers who care deeply about the lives of their patients. AvaSure believes that nurses should always be central to care, which is why we featured nurses throughout our summit – as moderators, hosts & panelists to demonstrate the vital role they play in the shifting care model moving forward.

We look forward to sharing more insights, recaps and full session replays of Digital Summit for those who have missed it.

1 Kroll, D. S. et al., (2020). Virtual monitoring of suicide risk in the general hospital and emergency department. General hospital psychiatry, 63, 33–38. https://doi.org/10.1016/j.genhosppsych.2019.01.002

Virtual Classroom Series Session 5: Selecting the Right Technology Partner for Virtual Nursing

webinar graphic

Once you’ve sold your teams on virtual nursing, picking the right partner is essential.

In this session, you’ll learn:

  • Criteria to use to select the right partner for program success & what requirements should guide your decision
  • How technology will impact your program and details around emerging trends towards AI/Machine Learning, camera-in-every-room, and more

This free, six-part series will take place the last Thursday of each month featuring Lisbeth along with special guests and experts. Lisbeth will cover key topics, lessons learned from ongoing programs, and audience questions. 

Virtual Classroom Series Session 4: Introducing the Expert Oversight TeleNurse™ Model

webinar graphic

This model of virtual nursing focuses on retaining an experienced nurse to oversee a cohort of complex patients, monitoring for early signs of adverse patient events, mentoring novice nurses and providing support to bedside care teams.

Hear from Lisbeth Votruba, RN, MSN, CCO of AvaSure and the team from UCHealth, Amy Hassell, RN, MSN, Director of Patient Services and Dr. Hemali Patel, ACMO of Inpatient Services. Amy and Dr. Patel work in the innovative Virtual Care Center at UCHealth which helps to support monitoring for patient deterioration, post rapid-response monitoring and more using the Expert Oversight model of Virtual Nursing. Hear about how their program started, outcomes they’ve experienced over the past year and roadblocks they’ve faced in scaling their virtual nursing efforts.

In this session, you’ll learn:

  • What’s driving the need for this nursing model, areas of focus and hear best practices from those who’ve already piloted.
  • Early outcomes from those already using this model to help detect adverse events sooner and drive satisfaction in nursing staff, especially novice team members.
  • Tips on staffing and scaling your virtual nursing program

Presenters:

Amy Hassell
 RN, MSN, Senior Director of Patient Services, UCHealth Virtual Health Center
Dr. Hemali Patel, MD, ACMO, Inpatient Services, UCHealth

This free, six-part series will take place the last Thursday of each month featuring Lisbeth along with special guests and experts. Lisbeth will cover key topics, lessons learned from ongoing programs, and audience questions. 

If 20% of RNs quit by 2027, could virtual nursing be enough to fill the gap?

Toby Eadelman

Some recent staffing survey results should be scary to health system leaders. A virtual nursing expert discusses the value of two emerging tele-nurse models, and how provider organizations can get started with them.

Virtual nursing has been getting an increasing amount of attention in healthcare, especially with telemedicine entering the mainstream during and following the COVID-19 pandemic.

Baptist Health has a successful virtual nursing program up and running, as does Providence. (For more on virtual nursing, click here and here and here.)

Toby Eadelman is chief technology officer at AvaSure, a virtual care technology and services company that works in virtual nursing. AvaSure has six virtual nursing implementations underway.

Eadelman attended HIMSS23 in April and said there was a lot of curiosity among attendees he talked with about virtual nursing. Hospital leaders told him they’re considering some form of virtual nursing but have not actually started a program because they don’t know where to begin.

Healthcare IT News spoke with Eadelman to discuss the state of virtual nursing and how healthcare provider organizations can benefit from these programs.

Q. You attended the HIMSS23 in April. What did you hear at the show about virtual nursing?

A. There was a lot of curiosity among health system and hospital leaders about virtual nursing. On more than one occasion, hospital leaders told me they were considering launching a virtual nursing program in some form but were unsure of where to begin.

The reasons behind this interest and curiosity are familiar to anyone who follows the healthcare industry – rapidly escalating labor costs and widespread staffing shortages.

For instance, according to a recent national survey of nurses, 100,000 nurses quit their jobs during the pandemic, and by 2027, nearly 900,000, or almost one-fifth of the 4.5 million registered nurses nationwide, plan to do the same, endangering the overall national healthcare system if no action is taken.

Both nurses themselves and hospital leaders understand the current approach to nursing is not sustainable, so they are looking to virtual nursing solutions to solve the problem.

Q. You say you’ve been seeing two models of virtual nursing emerging. The first model you call the “expert oversight tele-nurse.” Please describe how this works in-person and virtually.

A. In general, hospitals begin their journey into virtual nursing by employing one of the two primary models that have developed across the healthcare industry. One of those virtual nursing models is what we call the expert oversight tele-nurse model. In this approach, virtual nurses focus on overseeing higher-acuity patients for potential deterioration triggers, supporting novice nurses, and conducting virtual rounding.

An example of a hospital that has implemented this model is Colorado-based UCHealth, which reduced emergency “code blues” by 70% after implementing a virtual nursing program that improved detection of patients experiencing deterioration.

UCHealth has found that virtual nurses can observe changes in patients’ health status, just as they would if they were in rooms with patients, which has helped reduce phone calls and bedside interruptions for in-hospital nurses.

Separately, one hospital in the Southeastern U.S. has launched a virtual nursing program to decrease holding times in the emergency department by streamlining admissions from the ED to inpatient beds. Hospital leaders view this program as a means of supporting nurses on the frontlines without compromising patient safety or patient experience.

Q. The second model you call the “clinical resource tele-nurse.” Please describe how this works in-person and virtually.

A. The second model of virtual nursing, called the clinical resource tele-nurse model, is focused on using virtual clinicians for admission and discharge support, patient and family education, consults, and more. This model supports episodic intervention with two-way audio-video technology allowing personal interaction with the patient during important care events.

After having successfully implemented a virtual sitting program in 2020 in its medical surgical and intensive units, a hospital in the Southeast has launched a pilot virtual nursing program to decrease ED holding times by streamlining admission from the emergency department to inpatient beds.

The medical center sees this as a way to support nurses on the frontlines without compromising patient safety or patient experience.

Q. Where should healthcare provider organization health IT leaders interested in virtual nursing begin the process of starting a program?

A. The first step to starting a virtual nursing program is to identify the biggest challenges that are confronting the provider organization. Doing so will provide insights about unique pain points and clues about how to relieve them.

Gather a group of cross-functional stakeholders, including bedside staff, and listen to them describe the problems they encounter, which are likely to include challenges such as burnout and exhaustion, patient throughput bottlenecks, rising patient complexity, and retirement vacancies causing a lack of highly experienced staff.

Next, prioritize the challenges by greatest impact, build a compelling business case to health system executives about how virtual nursing will lead to financial and operational improvements, and select the right vendor partner.

To ensure success, do not attempt to DIY this. Partner with an experienced virtual care company that offers a system with very high uptime and very good audio and video quality. Ideally, a vendor with experience providing video and audio in the acute care space, for example, a tele-sitting company, and be sure they also have exceptional 24/7/365 customer care.

The ideal virtual care platform enables virtual team care by combining remote patient sitters, virtual nurses, and other providers in a single enterprise technology solution to enhance clinical care without placing any additional burdens on existing staff.

Once you’ve selected a tech partner, it’s time to select the first use case.

For a virtual nursing program’s first use case, it is advisable to start small to demonstrate early success. For example, consider launching in a single unit or department. After rolling out the first use case, spread the word about the virtual nursing program’s positive impact on staff and patients.

See the article on HealthcareIT News.

Virtual Classroom Series Session 3: Building a Virtual Nursing Business Case

webinar graphic

Join AvaSure Chief Clinical Officer, Lisbeth Votruba, MSN, RN, for Session 3! In this session, you’ll learn:

  • Learn how to partner clinical and IT resources to build a business case for virtual nursing
  • Identify key metrics to use as goals & benchmarks for your program
  • Get best practices for setting up an initial pilot & how to sell your leadership team on starting a program

Presenters: 

Lisbeth Votruba, MSN, RN, Chief Clinical Officer, AvaSure

Dana Peco, MSN, RN, Director of Clinical Sales, AvaSure

UCHealth slashes code blues up to 70% with telehealth technologies

UCHealth logo

UCHealth is a nonprofit healthcare organization based in Colorado made up of 12 hospitals across the state. UCHealth had already implemented AvaSure’s TeleSitter® for patient safety and VerifyTM for virtual ICU. Here, they looked at expanding the use of these technologies to create a program they call Virtual Deterioration. Keep reading to learn more about this new case use.

Challenge

Looking to identify deteriorating patients sooner
The organization had a new use case for virtual care, a program called Virtual Deterioration. Through this virtual platform, they were looking to identify patients who were deteriorating in the hospital sooner in order to provide rescue and treatment faster, enhancing better overall outcomes.

Solution

AvaSure reduced Code Blues by as much as 70%
Early outcomes using AvaSure to watch ICU patients for deterioration have shown significant promise in reducing cardiac arrests by as much as 70%. Additionally, UCHealth has seen an increase in rapid response events (26%-86%), while Code Blue rates are plummeting (down 25%-70%), mostly in high-risk areas. UCHealth is also tracking whether patients remain in their current environment instead of being transferred to a higher level of care after an event.

  • Up to an 86% increase in rapid response rates
  • Up to a 152% increase in post–rapid response vitals being ordered and completed

“And so if you are considering any sort of hybrid approach from, for example, a clinical command center or nursing workflows, you want to have a great platform that you feel your staff can use and interact with seamlessly and with ease.”

— Amy Hassell, RN, UCHealth

Read the full article on Healthcare IT News

How Jefferson Health turned a capacity crisis into an opportunity with virtual nursing

webinar graphic

There’s no telling what type of illness surges hospitals will see this year: Take lessons from Jefferson Health’s nurse-led virtual nursing pilot program here.

A surge in respiratory viruses over the fall and winter months placed immense capacity and resource strain on hospitals. This year, they can’t afford to wait and see what the next respiratory virus reason might bring.

In this session, leaders from Philadelphia-based Jefferson Health will share how a nurse-led approach helped the organization meet staffing demands during this past pediatric surge in respiratory syncytial virus cases. Colleen Mallozzi, RN, senior vice president and chief nursing informatics officer at Jefferson Health, and Laura Gartner, DNP, RN, clinical informatics director at the health system, will share how the team quickly expanded an existing virtual sitting program into a virtual nursing pilot to meet patient care and staffing demands.

Learning points:

  • The timely implementation of a systemwide virtual nursing pilot
  • The CNIO’s pivotal role in ensuring the clinical practice leads the technology and not the other way around
  • Critical steps to structure the program including the right setting, staffing, and outcome measurements

Presenters:

Colleen Mallozzi, MBA RN, SVP, Chief Nursing Informatics Officer, Jefferson Health

Laura Gartner DNP, MS, RN, NEA-BC, Division Director Clinical Informatics, Jefferson Health

Lisbeth Votruba, MSN, RN, Chief Clinical Officer, AvaSure

Virtual Classroom Series Session 2: Introducing the Clinical Resource TeleNurse™ Model: What is It and How Can It Help?

webinar graphic

Join AvaSure Chief Clinical Officer, Lisbeth Votruba, MSN, RN, for Session 2! In this on-demand webinar, you’ll learn:

  • How the Clinical Resource TeleNurse focuses on offloading documentation and administrative burden from bedside teams, helping to optimize your labor force and deliver elevated patient care
  • What’s driving the need for this nursing model, areas of focus and hear best practices from those who’ve already piloted
  • Early outcomes from those already using this model to help reduce discharge time, increase patient & staff satisfaction and optimize outcomes

Presenters: 

Lisbeth Votruba, MSN, RN, Chief Clinical Officer, AvaSure

Wayde Batt, MSN, NEA-BC, BC-RN, Patient Services Manager, NSICU/Virtual Nursing, UNC Health Rex

Laura Gartner, DNP, MS, RN, RN-BC, NEA-BC, Director Clinical Informatics, Jefferson Health

AvaSure Launches Virtual Nursing Application and Care Model

AvaSure virtual care graphic

With six virtual nursing implementations underway, AvaSure is leading the way in hospital virtual nursing deployments

BELMONT, Mich., April 25, 2023 — AvaSure, the inventor of the TeleSitter® solution and the market leader in acute virtual care and remote safety monitoring, announced today that it has launched a Virtual Nursing application and Care Model to support six virtual nursing implementations with many more in early planning phases.

Hospitals and health systems have been compelled to explore new models of nursing care during a period of escalating labor costs and widespread staffing shortages. For example, 52% of nurses are considering leaving the bedside, at a time when there are more than 1.1 million vacancies. Hospital leaders know the current approach is not sustainable, and experts estimate that 83% are considering virtual nursing as a solution.

To help hospitals and health systems respond to these growing market needs, AvaSure has recently launched several new virtual nursing-related initiatives.

AvaSure’s Nurse Elevated Care Model

As the pioneer in virtual sitting with the AvaSure TeleSitter® Solution, the company has expanded its offerings to support a more comprehensive nurse elevated care model. Consisting of virtual telehealth technology, and a team of nurses to support clinical technology adoption, AvaSure’s approach to virtual nursing represents an innovative new model of care that creates an augmented care environment where a virtual team provides support – offloading documentation burden, providing a second set of eyes on complex patients and helping to close the growing experience/complexity gap in nursing – to the bedside team.

To address growing labor challenges, six hospitals have recently adopted AvaSure’s TeleNurse™ solution, which enables health systems to reduce labor costs while liberating their bedside nurses to provide elevated, hands-on patient care.

“Nine out of ten hospital leaders say they’re considering some form of virtual nursing, but just a small percentage have actually started a program – why the gap? Many don’t know where to begin,” said Adam McMullin, CEO, AvaSure. “We have implemented our pioneering TeleSitter® solution in a thousand hospitals to establish virtual care. Many of these hospitals are now turning to us to partner on a virtual nursing program in order to reap further clinical, operational, and financial benefits from the AvaSure virtual care platform.”

Click here to learn how AvaSure customers have used virtual nursing solutions to improve HCAHPS scores, reduce code blues and decrease discharge times.

Two Models of Virtual Nursing Emerging

Some hospitals are implementing a model of virtual nursing called the Expert Oversight TeleNurse® that focuses on overseeing higher acuity patients for potential deterioration triggers, supporting novice nurses & conducting virtual rounding. In an article in Healthcare IT News, Amy Hassell, BSN, RN, CCRN, senior director for the Virtual Health Center for UCHealth, spoke about the key benefit of this model.

“They (virtual nurses) are able to see what’s occurring so that it’s just like we’re in the room with that care team member,” Hassell explained. “When we do this, it helps us cut down on phone calls and interruptions at the bedside, allowing us to still participate and do our part of the program. The program provides support and makes sure milestones of care are being met throughout that deterioration event, and help triage if needed.”

Several other hospitals are implementing a model of virtual nursing called the Clinical Resource TeleNurse® focused on admission & discharge support, patient & family education, consults and more. This model supports episodic intervention with two-way audio/video technology allowing personal interaction with the patient during important care tasks.

An East Coast hospital has expanded its AvaSure program from virtual sitting to virtual nursing, a simple process because both functions are performed via AvaSure’s virtual care platform. The transition will enable the health system to deliver a greater level of support to front-line nurses and bedside caregivers.

A Midwest hospital has implemented AvaSure’s TeleSitter® and TeleNurse™ solutions to integrate with its Epic electronic health record. The hospital is defining new workflows in which virtual nursing can make a difference in enhancing their care teams.

After having successfully implemented a virtual sitting program in 2020 with AvaSure in its medical surgical and intensive units, a hospital in the Southeast has launched a pilot virtual nursing program to decrease ED holding times by streamlining admission from the emergency department to inpatient beds. The Medical Center sees this as a way to support nurses on the frontlines without compromising patient safety or patient experience.

Medical-surgical Virtual Nurse Certification          

AvaSure Chief Clinical Officer Lisbeth Votruba, MSN, RN is participating as a subject matter expert on the task force that has defined the role of the virtual nurse and will be creating a medical-surgical virtual nurse certification from the Medical Surgical Nursing Certification Board, which will be launched later this year. Votruba pioneered virtual sitting and has published five studies helping to establish virtual sitting as a standard of care for patient safety in the hospital setting.

AvaSure Virtual Classroom Series: Virtual Nursing 101

AvaSure recently announced a six-part virtual classroom series, “Virtual Nursing 101,” in which Votruba details how nursing leaders can launch and implement virtual nursing programs. In the series, Votruba is joined by special guests and experts who cover key topics, such as the role of the virtual nurse, how to be certified, how to build a virtual nursing business case, as well as lessons learned from current programs. This free, six-part series takes place between March and August. To register, click here.

Read the press release 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 1,000 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