Jan 31 2024

5 Takeaways on Virtual Nursing Implementation from the ATA Insights Summit

Three healthcare leaders discussed their experiences with virtual nursing at a conference led by the American Telemedicine Association.

Interest in virtual nursing continues to grow as healthcare organizations look for innovative ways to address workforce challenges and retain valuable nursing staff.

Last year, the American Telemedicine Association’s annual conference and expo featured a host of sessions led by virtual nursing experts who shared key insights on how some healthcare organizations are already using their programs to support bedside nurses and veteran nurses alike. 

To extend those lessons further, ATA then hosted its Insights Summit on virtual nursing, a two-day event held in mid-November in Washington, D.C. I moderated a panel titled “Your Team Needs Help: Launching Your Virtual Nursing Investment.” Three healthcare leaders discussed their experiences implementing virtual support for in-person care.

Tearsanee Carlisle Davis, director of clinical programs and strategy for the Center for Telehealth at the University of Mississippi Medical Center; Kelsea Cox, director of patient care services at St. Luke’s East Hospital; and Hope Miller, senior vice president of clinical operations, home and community care at Optum, spoke about the benefits and challenges of their programs so far and highlighted the importance of clear change management.

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1. Make Nursing Stakeholders a Priority  

At UMMC, Davis said, a lack of nursing staff and nurse burnout were major concerns that contributed to re-examining virtual nursing as a necessary solution. The health system had previously tested virtual nursing in a critical care setting, but that program was short-lived. The chief nursing officer drummed up interest this time, and virtual nursing was once again on the table.

The chief nursing officer and her team, Davis added, kept nurses at the forefront of the virtual nursing conversation, even hosting sessions to hear what their biggest pain points were and how they thought the program’s success should be measured.

At the Kansas City, Mo.-based St. Luke’s Health System, nurse stakeholders play an important role in the ongoing improvement of an established virtual nursing program. 

“As a nurse, I want to be part of the group that is changing nursing. I don’t want someone to change nursing for me and tell me what to do with my profession,” Cox said. “The organization was really looking to the nurses to say, ‘How do you think we sustain this? How do we solve these problems?’”

WATCH: Atrium Health’s virtual nursing observation program mitigates clinician burnout.

2. Start with Existing Technologies 

Close collaboration with the IT team meant that St. Luke’s could use existing equipment for its virtual nursing program, repurposing what it already owned to save money.

UMMC also mostly stuck to that route. “We used what we already had. We use the monitoring system that was already in place in the organization,” Davis said.

Health services provider Optum, a subsidiary of payer UnitedHealth Group, offers in-home assessments for members through its HouseCalls program. Miller, a geriatric nurse by training, said that the COVID-19 pandemic spurred the organization to rapidly deploy virtual care in 2020. The federal telehealth allowances at the time made it easier to use FaceTime and Google Duo (which became Google Meet in 2022) so that the advanced practice clinicians could still provide care.

Miller said that that this became an opportunity to discover how much tech support figured into the deployment of virtual care, especially since many of Optum’s members are older adults.

“The amount of time during the appointment that was to be spent on fixing IT issues was not making this very scalable,” she said. That pushed the organization to stand up a dedicated IT team to help with tech issues during appointments.

READ MORE: Realize the power of virtual care solutions to better connect patients and providers.

3. Customize Your Virtual Nursing Program

Healthcare organizations can’t expect a one-size-fits-all approach to virtual nursing. They need to make sure their virtual nursing programs are tailored to their health system’s needs, Miller said.

One need could be releasing bedside nurses from repetitive administrative tasks that can be handled by someone who is not in the room. UMMC found that having a virtual nurse do admission paperwork freed up time for the bedside nurse to do more important, in-person tasks. The discharge process also became smoother and quicker using a virtual nurse.

“The virtual nurse, when they are with a patient, they are with that patient 100 percent. They're not being called away for other things,” Davis said.

Healthcare organizations must figure out their priorities and discover for themselves how virtual nursing aligns with their strategic missions.“That was one of the conversations we had in the beginning: What do the nurses currently do that can safely be done by someone who is not in the room?” Davis said. “So, we took those tasks away from the bedside nurse. They also have a team now, rather than feeling like they're the only nurse for this patient. They know that they have this help throughout the day.”

Tearsanee Carlisle Davis
The virtual nurse, when they are with a patient, they are with that patient 100 percent. They're not being called away for other things.”

Tearsanee Carlisle Davis Director of Clinical Programs and Strategy, Center for Telehealth at the University of Mississippi Medical Center

4. Emphasize Patient Consent and Privacy

Make virtual nursing consent part of the overall hospital consent process, Cox said. Patients must be made aware of audiovisual tools used in virtual nursing. At St. Luke’s, for instance, the camera is turned away from a patient until someone enters the screen, which is when the camera physically turns to face the patient. There’s also a chime sound to indicate virtual entering. These features help assure patients that they are not being watched 24/7.

UMMC also stresses the importance of patient education and consent. When nurses change shifts, patients are repeatedly informed about the program. “The nurse explains again, ‘I'm going to be coming in several times a day. I'll ask you if it’s OK before I turn my camera on,’ and over time, the patients become more comfortable with it,” Davis said.

EXPLORE: Clinical automation offers relief amid staff shortages and rising burnout.

5. Use Data to Improve Your Virtual Nursing Program

Patient feedback has been crucial to improving St. Luke’s virtual nursing program, Cox said. The organization found that patients who have a virtual nurse are more likely to rate their hospital experience as positive. The feedback has also contributed to changes in processes, such as altering evening hours to limit late-night virtual visits, since a glaring screen can disturb a patient’s rest.    

“Having that data, getting that data to units to get it to their bedside nurses to say, ‘Hey, this is something we've implemented. Here's how it’s serving us. Here is what the goal is. Are we reaching a goal or are we not? And here are some of the things that we're working on.’ Not only to make the life of the virtual nurse and our patients better, but also in the instances where the bedside nurses have to do these workloads, it's going to be better for them as well,” Cox said.

Though it’s a challenging approach, Cox recommended that health systems interested in implementing virtual nursing consider bringing on new units gradually rather than in one massive go-live. At St. Luke’s, adding a new unit to virtual nursing every two weeks within a span of several months allowed for better adoption.

“That was something that was really important to me, that we were able to keep taking that feedback and showing the nurses, we really care about your feedback. We want this to work for you. This isn’t something that we want to overlay on to your workload. We want it to work within your workflow. And so, that really helped us to do that,” Cox said.

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