By 2024, only 10% of hospital leaders and 14% of hospital IT leaders will have reached the stage where virtual nursing is a standard part of care delivery – in both groups, 30% reported no virtual nursing, according to a new study: “The Virtual Care Insight Survey,” from AvaSure, a virtual nursing technology and services company.
At the same time, despite the slow march to maturity of virtual nursing, 74% of hospital leaders believe that virtual nursing is or will become an integral part of acute inpatient care delivery models, compared to 66% in last year’s survey.
“The Virtual Care Insight Survey” was conducted online by Joslin Insight in partnership with the American Organization for Nursing Leadership on behalf of AvaSure. This research was a follow-up a survey from 18 months agocreating a longitudinal picture of how perceptions and strategies are rapidly evolving in virtual nursing.
The combined surveys received responses from more than 1,000 healthcare professionals (789 in 2023 and 340 in 2024), who primarily work in acute care.
At least 30% were nurse leaders or key decision makers, collectively referred to as “hospital leaders.” To complement the nurse survey, AvaSure collected insights from 29 hospital IT leaders (primarily CIOs) regarding the adoption of virtual care in inpatient care.
Key features of inpatient virtual care include virtual sitting, virtual nursing, episodic consultations, ambient listening, and generative AI.
We spoke with Lisbeth Votruba, RN, Chief Clinical Officer at AvaSure, to delve deeper into the study results.
Question: This year, only 10% of hospital leaders and 14% of hospital IT leaders have reached the stage where virtual nursing is a standard part of care delivery. In both groups of leaders, 30% reported no virtual nursing. What are the challenges of making virtual nursing a standard way of providing care?
A. Healthcare systems face significant and ongoing workforce challenges, particularly in attracting and retaining qualified clinical staff. These pose significant financial challenges for hospitals, limiting the time and budget for adopting and innovating with new technologies. Paradoxically, it is the new technologies that will support a transformation in healthcare delivery needed to address these workforce challenges.
Although by 2024, the nurse shortage will almost transition from acute to more chronic 900,000 additional nursesor roughly one-fifth of the 4.5 million registered nurses nationwide plan to leave by 2027 due to stress, burnout and retirement. When faced with these types of shortages, projects such as launching virtual care – despite its ability to reduce healthcare workforce burdens – are perceived as cumbersome.
Many stakeholders recognize the importance of nurses working at the top, but few are paying attention to the acute shortage of unlicensed support staff who are essential to achieving this goal. Nursing assistant turnover continues to increase year after year, is currently at 42%.
Given these financial constraints, hospital CIOs must quickly demonstrate return on investment for new technology initiatives. Fortunately, virtual care contributes to this. Hospitals can start with virtual observation of sitting safety, which can then lead to rapid improvement in reducing the number of falls and other adverse incidents, shorter patient stays and reduced risk.
Over the long term, investments in virtual nursing have the power to generate substantial growth in critical metrics related to patient and staff satisfaction.
Q. This year, 46% of hospital leaders are piloting or implementing virtual nursing. That number has grown from 38% a year ago. Nearly half is quite large for an area of virtual care that is relatively new. What factors drive these hospitals and healthcare systems?
A. There are several stages on the path to maturity in virtual care. Virtual care is far from an all-or-nothing or one-size-fits-all model. The providers who are having the most success with virtual care view it as a phased process that begins with select implementations of virtual sitting or virtual nursing solutions.
Most organizations launching virtual care programs are starting with virtual sitting, which allows virtual security guards to watch over patients via video and audio connections, improving patient safety. Additionally, a typical 250-bed hospital can save more than $2.5 million in costs annually by replacing up to 75% of one-on-one sitters with continuous monitoring.
After the virtual sitting phase, organizations often transition to virtual nursing. This can take the form of one of two effective models. First, the clinical resource model uses virtual nurses to handle documentation and free up frontline staff for direct patient care.
Second, the expert supervision model uses experienced virtual nurses to supervise a group of complex patients while also providing clinical insight and mentorship to the nursing staff. At each stage, virtual nursing can remain cost-neutral by rolling ROI from one stage to the next.
Q. 74% of hospital leaders believe virtual care is or will become an integral part of acute inpatient care delivery models, compared to 66% in last year’s survey. 74% is much larger than the 46% with active programs. What do these other executives see that is so promising for them?
A. Healthcare leaders across the spectrum understand that the promise of virtual nursing is about transforming the way care is delivered to make it more accessible, efficient and patient-focused. These leaders see virtual care as a catalyst to expand access to specialty care, reduce workforce costs, improve nurse well-being and improve patient safety.
Here are two real-life examples.
Virtual sitting saved St. Luke’s Duluth $1.5 million by 2023, The reduction targets were maintained and personnel costs decreased. The program helps the hospital optimize staff efficiency by offloading routine observation tasks to virtual sitters, allowing clinical staff to focus on other critical aspects of patient care.
And researchers surveyed 74 nurses from Renton, Washington-based Providence and found that virtual sitting improved their “emotional labor” and “emotional exhaustion” compared to sitting in person. The research shows that virtual sitting improves nurses’ well-being and helps maintain patient safety.
Q. What does your research show that leaders see as the top use cases for virtual nursing? And why do you think these are the top areas?
A. Our research shows that healthcare providers are using virtual care to solve their most pressing problems. The top use cases for virtual care are therefore virtual sitting (39%) and transferring documentation, especially for patient discharges and admissions.
Firstly, it is no surprise that virtual sitting is the most used application. It allows trained, unlicensed security personnel to use video and audio connections to watch over multiple patients and improve overall safety, making it a natural starting point.
Virtual safety observation has been proven to deliver better patient outcomes – often a 50% reduction in falls across the organization. In addition to reducing the number of patient falls, the solution also reduces interference from hoses and pipes and ensures staff safety from possible patient aggression. Virtual sitting has been proven to deliver an immediate and measurable ROI for hospitals.
Second, virtual technology plays an important role in expediting the discharge of patients in hospitals; this is achieved by streamlining processes, improving communication and improving access to care. Nurses and care managers can use virtual platforms to inform patients and caregivers about discharge instructions, reducing the need for in-person meetings and allowing for greater flexibility.
Virtual tools connect hospital staff with remote providers in real time, ensuring smooth transitions and eliminating delays in securing services after discharge. Virtual technology automates documentation and paperwork so necessary forms can be processed faster.
Finally, expert virtual nurses can provide clinical surveillance of high acuity patients in both intensive care and medical/surgical settings. They can respond to triggers from their electronic health record and monitor patients during the critical few hours after a rapid response call, ensuring expert care is delivered in a comprehensive and timely manner.
At the same time, virtual nurses can provide real-time mentorship and confidence to more novice nurses at the bedside, nurturing a nursing workforce for the future.
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