Transforming Patient Care through Virtual Sitting at Madonna Rehabilitation Hospitals

About Madonna Rehabilitation Hospitals

Madonna Rehabilitation Hospitals, with campuses in Lincoln and Omaha, Nebraska, specializes in the rehabilitation of patients who have experienced strokes, spinal cord injuries, brain injuries, and other complex medical conditions. Collaborating with acute care hospitals nationwide, Madonna ensures seamless patient transitions into rehabilitation care.

In 2016 Madonna partnered with AvaSure to implement a virtual sitting program. This program deployed virtual attendants to monitor at-risk patients through video and audio connections, replacing the costly and inefficient one-to-one sitter model. Operating out of a virtual command center at one of Madonna’s facilities, the program successfully reduced costs and enhanced patient safety.

Challenge

As the nursing labor shortages persisted, Madonna identified the need to develop new models of care to meet patient care and safety needs. To address this, Madonna aimed to replace its onsite virtual sitters with remote sitters, thereby reallocating resources to bedside care.

Building on its successful collaboration with AvaSure, Madonna engaged Equum Medical, AvaSure’s hosted monitoring partner, to implement remote sitters. The new program aimed to augment the capacity of Madonna’s clinical staff, improving patient access and maintaining high safety standards.

Purpose/Objectives

As the nursing labor shortages persisted, Madonna identified the need to develop new models of care to meet patient care and safety needs. To address this, Madonna aimed to replace its onsite virtual sitters with remote sitters, thereby reallocating resources to bedside care. Building on its successful collaboration with AvaSure, Madonna engaged Equum Medical, a leader in telehealth-enabled clinical services and AvaSure’s hosted monitoring partner, to implement remote sitters. The new program aimed to augment the capacity of Madonna’s clinical staff, improving patient access and maintaining high safety standards.

Methodology

With the AvaSure virtual sitting program in place, the transition to use the virtual sitting services was completed in just six weeks. The implementation process emphasized the seamless integration of Equum virtual safety staff into Madonna’s patient care workflows. A priority was fostering trust and collaboration between onsite nursing staff and the remote Equum team to standardize and optimize workflows. This included establishing efficient protocols for virtual sitting utilization to prevent falls and ensuring clear alarm response communications.

Outcomes

The implementation of the virtual sitting program at Madonna Rehabilitation Hospitals yielded significant and positive outcomes. By replacing traditional one-to-one sitters with remote virtual attendants, the hospital achieved several key improvements:

• Increased Staffing Capacity: The program enabled the reallocation of 11 FTEs from patient monitoring to direct patient care, enhancing bedside nursing support.
• Enhanced Patient Safety: The virtual sitting program effectively prevented 186 falls and 97 elopements in a short timeframe, demonstrating its positive impact on patient safety.
• Improved Patient Access: The increased staffing capacity allowed for the admission of more patients with traumatic brain injuries, expanding access to critical care services.
• Cost Reduction: The virtual sitting program generated cost savings by reducing the need for one-to-one sitter staffing.

Key Lessons Learned

Madonna Rehabilitation identified several crucial lessons from their experience:

• Integrate Virtual Technology: Virtual technologies, from telehealth visits to virtual sitting and nursing, are vital for delivering high-quality, cost-effective care. It is essential to adopt flexible technologies that align with organizational goals and care delivery strategies.
• Achieve Technology Adoption: The success of new technology hinges on staff adoption. Without full utilization, the anticipated benefits cannot be realized. Start with a specific project and set clear, measurable objectives that address adoption and optimization. Share initial successes to build organizational buy-in.
• Prioritize Change Management: Transparent communication and strong collaboration with front-line teams are essential for achieving buy-in and ensuring smooth integration of new technology. This approach helps relieve the burden on clinical staff rather than adding to it.

Through its innovative use of virtual sitting and virtual care, Madonna Rehabilitation Hospitals have not only addressed staffing challenges but also enhanced patient care and safety, setting a precedent for future healthcare innovations.