Read our white paper on how the Nurse Elevated Care Model can help reduce labor costs and allow bedside nurses to spend more hands-on time with patients.
Summary
Nursing shortages, patient acuity increase and an uptick in behavioral health challenges have created a perfect storm in healthcare. Nurses are being stretched too thin, constantly asked to do more with less resulting in 52% of nurses considering leaving the bedside when shortages are already at an all time high. This environment forces hospital leadership to think differently about how technology can help create a new model of care delivery.
Introducing the Nurse Elevated Care Model by AvaSure. 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 growing experience/complexity gap in nursing – to the bedside team. This model of care helps health systems reduce labor costs while liberating their bedside nurses to provide elevated, hands-on patient care.
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Now, the most proactive healthcare organizations are exploring initiatives to mitigate the effects of a growing labor shortage. Learn how central video monitoring enabled “virtual nurses” to support bedside nurses and uphold high standards of patient care amid a COVID-19 surge across Houston-based Memorial Hermann Health System.
Key learning points:
The basic components of virtual care, including the easy-to-use technology involved to interact with patients and bedside staff
The policies and workflows that best support virtual nursing staff and make for easy implementation
How virtual nurses can use specialized care resources to alleviate existing staff
Join AvaSure Chief Clinical Officer, Lisbeth Votruba, MSN, RN, as we kick off a six-part classroom series: Virtual Nursing 101. Lisbeth had a special guest Terri Hinkley, CEO of the Academy of Medical-Surgical Nurses on this first webinar to discuss the important role of the virtual nurse and the creation of the MSNCB Role Certification. The two task force members of the certification dived into key competencies to look for when hiring a virtual nurse and how to recruit for this role without taking away from bedside staff or further exacerbating staffing challenges.
Introducing the Nurse Elevated Care Model from AvaSure
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 growing experience/complexity gap in nursing – to the bedside team. This model of care helps health systems reduce labor costs while liberating their bedside nurses to provide elevated, hands-on patient care.
52% of nurses are considering leaving the bedside, at a time where there are 1.1M+ vacancies. Hospital leadership knows they need a change, 83% are considering virtual nursing as a solution but don’t know where to start.
We call this the Nurse Elevated Care Model because it does just that – elevates your nursing team for optimal care.
Learn how AvaSure customers have used the Nurse Elevated Care Model to achieve results
Sarah Brown MSN, RN, CMPE, NEA-BC at UnityPoint Health, discusses the challenges her nursing staff faced during the pandemic and how this caused massive burnout throughout their system. Quality of care was being compromised, so leadership agreed to make innovative changes and identified the use of AvaSure TeleNurse™ solutions as a potential solve. Sarah noted, “Virtual Nursing in the med-surg area immediately helped our nurses at bedside and has grown astronomically quickly.”
Early results of TeleNurse™ Programs:
Increases in HCAHPS: 7.6% increase in patient understanding of purpose of taking medication, 2.04% increase in top box score for transition of care
Discharges completed by the virtual nurse currently have lower rates of readmission – this is an early trend; they’re waiting to see more results over time to consider it correlated
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
Are you thinking about implementing virtual nursing but are not sure where to start? Or have you tried out things that don’t quite meet your objectives? You aren’t alone!
Join AvaSure’s Chief Clinical Officer, Lisbeth Votruba, MSN, RN as she navigates you through your program and how to get started in a 6-part educational series. Lisbeth is a pioneering nurse executive committed to continuous improvement of healthcare and the diffusion of new technologies to drive patient and staff safety. She was selected as a participant at the recent Medical Surgical Nursing Certification Board task force meeting to develop a certification for the virtual nursing position and for nearly 15 years, she has worked extensively with over 1,100 hospitals in standing up their virtual care platforms to help optimize labor forces, improve the quality of patient care and drive staff satisfaction & retention.
This free, six-part series features Lisbeth along with special guests and experts who will cover key topics and lessons learned from ongoing programs.
Session 1: The Role of the Virtual Nurse
Featuring Terri Hinkley, EdD, MBA, BScN, RN, CAE, CEO of Academy of Medical-Surgical Nurses
Learn about the role of the virtual nurse and what was involved in the creation of the MSNCB Role Certification from two task force members.
Understanding competencies to look for when hiring a virtual nurse and how to recruit for this role without taking away from bedside staff or further exacerbating staffing challenges.
Session 2: Introducing the Clinical Resource TeleNurse™ Model – What is it and How Can it Help?
Featuring 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
This model of virtual nursing focuses on offloading documentation and administrative burden from bedside teams, helping to optimize your labor force and deliver elevated patient care
In this session, learn what’s driving the need for this nursing model, areas of focus and hear best practices from those who’ve already piloted
Discover early outcomes from those already using this model to help reduce discharge time, increase patient & staff satisfaction and optimize outcomes
Session 4: Introducing The Expert Oversight TeleNurse™ Model: What Is It & How Can It Help?
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
In this session, learn what’s driving the need for this nursing model, areas of focus and hear best practices from those who’ve already piloted
Discover early outcomes from those already using this model to help detect adverse events sooner and drive satisfaction in nursing staff, especially novice team members
Including Virtual Nursing Best Practices from AvaSure’s Experienced Clinical Support Team
Hospitals across the U.S. are challenged with nursing shortages, a rise in patient complexity and unprecedented cost challenges. Nurses are being stretched too thin, constantly asked to do more with less. This environment is causing 52% of nurses to consider leaving the bedside at a time when labor is already a challenge. Hospital leadership is being forced to think differently about how technology can help create a new model of care delivery.
89% of hospital leaders say they’re considering some form of virtual nursing, but only 2% have implemented a program – why the gap? Many don’t know where to start.
Are you in the 2% that have already started their virtual nursing journey? We can help no matter what phase you’re at! Schedule a complementary on-site assessment to get started with AvaSure.
For those still concepting, with our extensive experience helping over 1,000 hospitals across the U.S. with their virtual sitting and virtual nursing programs – we’ve put together a 7-step roadmap for starting your virtual nursing program.
1. Identify your facilities unique pain points
It’s important to identify your biggest challenges within your organization. What’s unique about your facility and where should you focus efforts?
To help identify the top pain points, gather a group of cross-functional stakeholders including bedside staff. Ask them to provide feedback on what they are struggling with day-to-day.
Expect to hear things like:
Retirement vacancies causing a lack of highly experienced staff
Burnout & exhaustion of staff members of all types – from nurses to CNAs to physicians
Novice nurses feeling overwhelmed and unsure if they’re doing a good job
A rise in patient complexity
Quality metric declines across key areas
Patient throughput challenges & bottlenecks
Once you’ve cataloged what your staff is dealing with, you can get to prioritizing.
2. Prioritize the challenges with the greatest impact
Once you understand challenges across the facility, work to identify which is creating the biggest drain on the system.
We see two models of virtual nursing that customers are starting with first to address their top challenges – based on ease and the biggest impact:
Clinical Resource TeleNurse™ Model: a virtual nurse offloads documentation burden, giving bedside teams more time for direct, hands-on patient care
Admission & discharge support
Medication reconciliation
Patient & family education
2-nurse sign-off
Expert consultation
Expert Oversight TeleNurse™ Model: a virtual nurse oversees a cohort of complex patients providing clinical insight & nurse mentorship
Review & respond to clinical triggers from EHR and/or physiological monitoring
Expert nurses provide guidance and mentorship to novice nurses on the unit
Proactive patient rounding
Support satellite facilities with expert interventionists/specialists
We are confident one of these virtual nurse models would be a great place to start and to solve your greatest challenges.
3. Build your business case
Building a business case to sell your organization on starting a virtual nursing program is essential to ongoing success. The collaboration between clinical and IT leadership is key in this stage and to document how an IT infrastructure can help support clinical needs, not just today but for the future.
Once you’ve identified the model of virtual nursing with the most impact for your facility, begin to identify goals and benchmarks for your program.
Best practice from AvaSure’s clinical team: Be sure to include feedback from front line staff and managers, bringing them along in the process. Their buy in will be essential long-term. Make sure your care teams understand this program is designed to help them, not add more work to their plate or eliminate jobs.
4. Select a vendor partner
The final piece of your business case will be to choose a virtual care partner that can help you achieve your long-term goals. It’s important to select a partner that has both clinical & technical expertise and will help grow your program over time.
When evaluating vendors, be sure to consider:
Platform ease of use
Be sure to select a vendor that offers a platform that supports multiple clinical use cases that is easy for nurses to use.
Support
There is a lot of clinical change & workflow management when implementing a change to the care model, select a vendor with expertise who will partner with your clinical teams throughout this process.
IT teams also have a lot on their plates and shouldn’t be overburdened with implementing a new platform. Consider a vendor who provides robust technical support including project management and 24/7 support – not just at the time of deployment, but throughout the partnership.
Demonstrated outcomes
In any emerging area, a lot a new solutions will become available with little experience. In the clinical space, it’s more important than ever to select a partner with demonstrated experience in delivering outcomes for our patients.
Current technology
Vendor consolidation is key for maximizing the impact of current spend and reducing technology duplicity. Before adding a new vendor, consider if any current solutions – such as your TeleSitter® solution – also offer virtual nursing solutions before investing in additional technology.
5. Roll out your first use case
Now that you’ve identified the challenges, started formulating a business case with IT and have leadership on board it’s time to start building your program. You can start with a single unit or department if you’d like.
It’s good to start small, helping to demonstrate early success. Consider perhaps starting with peak hours – such as only between 9 a.m. – 9 p.m. to help ease staff into the program and staff the virtual team successfully.
But be flexible, consider that you may identify in real time that this isn’t the most impactful area to be addressed. Be willing to adapt and change quickly. It’s imperative that you get some quick wins under your belt to gain buy in from front line staff and garner continued support from leadership, so an agile approach can help.
When deciding what unit to start on, think about the following:
Highest churn unit for admission & discharges – may be a high need for offload of documentation
Unit with highest amount of novice nursing staff – may benefit from expert oversight & mentorship
Unit with highest percentage of travel nurses – may benefit from expert oversight or clinical resource
Considering using virtual nursing for specialists that low staffed – nutritionists, diabetic management, wound care, social workers/case managers & more
Assist with morning rounds on units with residents using virtual nurse to facilitate documentation to communicate with family
Units with high complexity patients allowing virtual nurse to do purposeful rounding being a second set of eyes on patients
In conjunction with units that have deterioration or sepsis protocols and/or wearable monitoring to help reduce false alarms and identify early signs of adverse events
Be sure to build in a feedback loop to hear directly from front line staff on how the program is going and have a way to share wins across the facility and with leadership. This positive word of mouth is what will really sell the program.
6. Share results with stakeholders and spread the word
After a few weeks or months, ensure you hold a forum with leadership and the cross functional teams involved in the early discussions to update them on your progress. Show how the pilot has driven change against your key goals or metrics. AvaSure’s clinical team will help you pull your data and showcase your progress.
Tip from AvaSure’s Customer Success Team: it’s important to have a baseline before starting so you can demonstrate change, be sure to log all metrics before implementation in addition to any financials.
Best practice from AvaSure’s clinical team: Include great catches & stories from front line leaders. While metric moving is great, it’s the stories that will win the hearts of your teams.
7. Scale up your program – you’re really doing it
Now that you’ve demonstrated success (and it was easy!) identify additional units to cover or consider expanding to a second model of virtual nursing. But be reasonable about what your team can take on at once. Go slowly & deliberately, making sure your teams have a venue to speak up if it’s too much.
Worried about staffing your virtual nurse program? Learn about hosted options if you don’t have adequate talent to pull from in your area.
A successful virtual nursing program can not only help with labor challenges, helping to optimize the productivity of your staff but it can also help to drive nurse satisfaction & retention. Nurses will feel more supported, get more time at the bedside, and leave feeling accomplished. AvaSure can help support you through every step of scoping, implementing, and scaling a virtual nursing program. With 15% of our staff being RNs, we understand the unique challenges of care systems today and have a robust clinical team to help from business case development through implementation, metric tracking, expansion.
Program distinguishes those who have advanced patient safety and achieved new efficiencies in care delivery.
BELMONT, Mich., Jan. 25, 2023 — AvaSure, the inventor of the TeleSitter® solution and the market leader in acute virtual care and patient safety monitoring, today announced the winners of the 2022 AvaPrize awards.
The AvaPrize awards honor 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 virtual care as it becomes a vital tool in patient care and staff augmentation throughout a healthcare organization.
“Every day across the nation, healthcare organizations rely on AvaSure’s solutions to enhance patient safety, augment bedside care, and improve the efficiency of care delivery,” said Adam McMullin, CEO, AvaSure. “We are proud to recognize these distinguished organizations and individuals – out of more than 1,000 of our hospital customers – who have demonstrated their commitment to advancing clinical quality and patient outcomes.”
The honors include:
The Safety Net Award for the organization that demonstrates the most complete AvaSure TeleSitter program. The award went to MaineHealth, which has improved patient safety through fall prevention and increased nursing job satisfaction through its TeleSitter program. In addition to fall prevention, Maine Health has monitored 1,928 patients who were at low to moderate suicide risk, helping these vulnerable patients continue their journey of emotional and physical health.
The Path to Zero Award for the organization with the most impressive fall reduction program centered around the TeleSitter program. The award went to ShorePoint Health for significantly reducing fall rates across multiple locations by up to 46% in their first year of implementation.
The Super Star Monitor Staff Member Award for the individual who consistently goes above and beyond to help measure success and uphold effective use of the AvaSure TeleSitter. The award went to Diane Norris of the remote visual monitoring team at ProvidenceHealth & Services-Oregon Region. Norris prioritizes building relationships with patients and delivering exceptional bedside care. She was a Providence caregiver for nearly 26 years before joining the remote visual monitoring team over a year ago. For Norris, it’s about connecting with patients in a whole new way. Many just want someone to talk to, especially during COVID, when capacity was limited for guests.
The VA Healthcare System Award for the U.S. Department of Veterans Affairs hospital that optimizes use of the AvaSure TeleSitter solution. The award went to VA North Texas Health Care System, which has monitored more than 2,500 patients through its TeleSitter program, increasing the utilization rate from 45% to 78%, greatly improving safety and efficiency measures.
During National Nurses Month in May, VA North Texas Health Care System nurse Juliet Aninye, LVN, Lead for the AvaSure TeleSitter Program, was honored with the Department of Veterans Affairs 2022 Secretary’s Award for Excellence in Nursing and Advancement of Nursing Programs.
Aninye was recognized for her leadership in the delivery of patient care through the utilization of the AvaSure program. The VA National Nursing Awards reflect the high-level of professionalism and excellence in service VA nursing represents.
1 virtual nurse per 100 M/S beds that assists with 55-60% of patients
At admission complete the questionnaire & can scribe physical assessment of onsite nurse, work on care plans, virtual patient education, core measures, make follow up appointments and lead discharge process including compiling all discharge information, ensure follow up appointments are lined up & medication reconciliation
Early Outcomes:
On average, virtual nursing saves 12 minutes per admission and 15-29 minutes per discharge, giving time back to bedside teams for patient care
During first 6 months, 107 catches in discharge errors that could have been significant patient harm. The panelist noted, “while bedside nurses may have caught these errors prior to discharge, the virtual nurse can be laser focused on these specific tasks without the distractions of a typical floor nurse.”
Patient who was about to be discharged on 2 blood thinners
Diabetic patient being discharged without Insulin education
New CHF patient without proper medication prescription at discharge
Discharges completed by the virtual nurse currently have lower rates of readmission – this is an early trend; they’re waiting to see more results over time to consider it correlated
Increases in HCAHPS:
7.6% increase in patient understanding of purpose of taking medication
2.04% increase in top box score for transition of care
Qualitative feedback from patients that they enjoy seeing a nurse without a mask on, can smile & interact more genuinely and can assist with hearing impaired patients who read lips.
UCHealth: expert ICU nurse helping monitor high risk critical patients for sepsis, deterioration, and other adverse outcomes
Program Overview:
3-4 virtual nurses monitor up to 1,800 patients within the system
Provide surveillance and early detection support aimed primarily at sepsis
Partner with novice bedside nurses providing help due to high turnover & lack of bedside experience
Work with other technologies that scan EHR and physiological monitors for triggers helping to identify patients in need of extra care
Monitor patients post rapid response to help detect rebounds
Early Outcomes:
Reduction in non-present on admission sepsis mortality & have seen compliance go up
Increase in rapid response calls
Unprecedented 25-70% code blue reduction in acute care areas, in combination with program on deterioration education
Bedside nurses have praised the program in making them feel more supported & secure in their roles
Great Catch: A post seizure patient was being monitored remotely and the virtual nurse (VN) could tell the patient was going to throw up. The expert VN was able to walk the bedside nurse through the steps to handle the situation – including fetching suction and calling the doctor. The doctor was able to help prevent the patient from aspirating. This gave peace of mind to the bedside nurse who was dealing with this situation for the first time.
Tips for getting started with virtual nursing
Our panelists shared a number of best practices when it comes to building out your own virtual nursing program – but their biggest advice was to, “just do it!” While starting a program can be daunting, they both feel that the benefits have outweighed the work.
Some of their tips are:
Whatever process you’re designing for needs to make sense and solve a bedside need. It needs to make life easier for the end user and be integrated in a way that makes sense in building a team effort approach for care.
Be sure to clarify for the team what virtual nursing is – but more importantly what it is not to all team members involved
Building a virtual nursing program is an iterative process – be willing to adapt as you get feedback from the front-line teams
When staffing your virtual team, look for nurses with multiple years of experience who can bring a level of wisdom to the role and can take a wide-angle lens on the patient population allowing them to catch things the bedside team may not. In addition to experience, soft skills are key. Look for collaborators who love to teach, have high emotional intelligence, and want to mentor other nurses
Have courage to try! Start a program, build some buzz around it. There’s a lot of work in this, but it’s good work, so give it a shot.
What’s next for virtual nursing
So, as early innovators in this space, where do they see their programs going in the future? Unity Point is focused on scale and standardization. They’re currently focused on creating a standardized, sustainable structure across their enterprise when it comes to technology, job descriptions, and everything else operational that goes with virtual nursing including creating a centralized leadership structure for the program. UCHealth is looking at expanding use cases of the program including virtual specialist care for areas such as wound care and respiratory therapy where they currently lack adequate staff across the system. They’re also exploring how a virtual nurse could assist with dual sign off activities such as checking blood & verifying high risk medications. Their ideal future state is one where an expert nurse is always a “call away” for a novice nurse who, for instance, is working night shift and has never placed an NG tube before, creating a culture of support and mentorship in all care settings.
Interested in your own virtual nursing program but not sure where to start? Our AvaSure RN’s can complete a free, on-site assessment of your facility and help in creating a business case based on your individual use cases. Request an assessment here and we will be in touch. We look forward to helping you transition to this exciting new model of supporting nurses through virtual care.
