Trinity Health examines in-hospital virtual care model

Patients soon may be interacting with on-screen nurses to address shortage.
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The new virtual care model will allow nurses who may be physically tired from the demands of in-person nursing to continue to utilize their knowledge and skills in a new way. Courtesy iStock

In an effort to find creative ways to tackle talent shortages in the health care field, Trinity Health leaders are preparing to roll out virtual nursing capabilities at its hospitals statewide in which patients would be interacting with on-screen nurses.

The new virtual care model, which is called the Virtual Connected Care Program, was initially piloted in January 2022 at Trinity Health Oakland Hospital in Pontiac.

According to Doug Dascenzo, regional chief nursing officer, Trinity Health Michigan, the program went through another iteration in June 2022, and by September, Trinity was “confident that the model was replicable.”

“We were striving to find a way to care for our patients safely and provide high quality care in the face of a staffing crisis, particularly registered nurses,” Dascenzo said. “Our charge was to find a way to decrease the demand for registered nursing services, while still delivering the care that patients required.

“We started out by developing the virtual component, but we also partnered every registered nurse with a licensed practical nurse. So, the model of health care delivery involves three people: the direct care nurse, the virtual nurse and the licensed practical nurse. That’s how we got started.”

The Virtual Connected Care Program provides a three-person care team model that works in tandem to provide for the patient’s needs.

“Patients will always have a registered nurse assigned to their care to supervise and evaluate the care that’s being delivered,” Dascenzo said. “That probably won’t feel like a change. Where it might feel a little different is (when) a virtual nurse upon permission of the patient is able to enter into an encounter with the patient. And essentially what they do is ensure that the patient understands the plan of care for the day.

“They will often respond to requests for assistance that come from the patient. And in this model, either the virtual nurse can initiate that contact or the patient can initiate the contact with the virtual nurse. In the model that we’re developing, the patient doesn’t always have to press a call bell and wait for a response. The patient can initiate the encounter with the virtual nurse, and the response is almost immediate. And it’s helpful too that the patient can see the individual with whom they’ve encountered and worked through any issues that the patient identifies.”

With this new model, instead of waiting for a nurse or caregiver to return to the patient’s room to answer questions, provide support, or check patients out, virtual nurses are able to provide on-demand aid as needed, without a wait.

Despite being on-screen rather than physically present with the patient, Dascenzo said there are “very few limitations” on what virtual nurses can do for patients.

“Maybe the only one that comes to mind is the fact that the virtual nurse can’t put his or her hands on the patient,” he said. “They can answer questions that the patient, family member or even providers seeing the patient might have. They are integral in coordinating care and communication. So, care with several disciplines like therapist, social worker, a patient, the family that can all be done at the same time. They can arrange for discharge teaching to be done and assure that the patient understands everything that’s being communicated to them.”

Additionally, Dascenzo said virtual nurses are able to give patients 100% of their attention and focus, providing the best care possible as they have “no competing demands” as nurses present in the hospital setting often do.

So far, he said the program has been a success, proving that the virtual care model not only measures up to traditional care models but also improves upon them — providing a better patient experience.

“We’ve seen that they (virtual nurses) don’t just fill in the gaps, they are actually able to proactively anticipate the needs for the patient as opposed to the patient or the family having to initiate those questions,” said Christie Sansom, vice president and transformation officer, Trinity Health. “That’s really the incredible benefit of this team model.”

Another benefit, Sansom said, is the ability of the virtual model to pair early career nurses at the bedside with more experienced virtual nurses, who are able to provide critical thinking and expertise to help younger nurses as needed. She also added that while all virtual nurses for the program will be experienced, they will not be required to have a bachelor’s degree, which she hopes will allow Trinity Health to recruit more virtual RNs.

Additionally, the new virtual care model will allow nurses who may be physically tired from the demands of in-person nursing to continue to utilize their knowledge and skills in a new way. Older nurses or those who are no longer able to compete with the physical demands of hands-on care can still make a positive difference in the lives of patients, continuing to use their skills to care for patients.

“As a nurse, I don’t think that the desire (to care for patients) ever goes away,” said Sansom. “To be able to continue to make that impact not solely on our patients and their families, but (also) on our early career nurses that are just joining our profession — our virtual nurses have told us repeatedly about how beneficial and how much of an impact they feel like they are making in this role.”

According to Sansom, the goal for 2023 is to continue to learn how to implement the virtual care model, supporting nurses and partners in preparation to implement the Virtual Connected Care program across the Trinity Health system “in the next couple of years.”

While Sansom was unable to provide a specific timeline for the implementation of this new model, between the addition of new tech and the training time necessary to make this new health care model run smoothly, West Michigan patients may have to wait some time to see virtual nurses implemented in local Trinity hospitals.

This story can be found in the Jan. 23 issue of the Grand Rapids Business Journal. To get more stories like this delivered to your mailbox, subscribe here.