New care model uses a ‘virtual nurse’ to interact with the patient in ways appropriate to the level of care
Clinical laboratories and pathology groups aren’t the only healthcare organizations currently experiencing critical industrywide shortages. A chronic nursing shortage is prompting hospitals like Covenant Medical Center in Lubbock, Texas, to invent unique ways to circumvent this issue while still managing to provide exemplary patient care.
Covenant, an affiliate of Providence—a 51 hospital/1,000 clinic healthcare network spanning Alaska, California, Montana, New Mexico, Oregon, Texas and Washington—piloted a hybrid nursing model called “Co-Caring.”
The model “uses virtual nursing to care for patients and support the bedside team through two-way audio and video telehealth technology,” according to a Providence news release. This allows nurses to focus on more vital roles, such as administering medication and assessing patients’ conditions, while day-to-day tasks are performed by assistants and virtual nurses.
After operating successfully for one year at a 30-bed unit within the 381-bed Covenant, the Co-Caring model was expanded to 10 other units in hospitals operated by Providence where it reduced the workload for bedside nurses, increased caregiver collaboration, and resulting in financial benefits for the facility.
“This pilot is not about one unit in one hospital,” Julie Wright, RN (above), who at the time was a Nurse Manager at Covenant, in a Providence news release. “It is about taking the first steps to changing how we care for our patients. We are working on creating an environment where burnout is the exception and not the rule, and where joy is the expectation.” Clinical laboratories might use a similar approach to enable pathologists and clinical laboratory scientists to dedicate their time to higher-value tasks. (Photo copyright: LinkedIn.)
Elevating the Practice of Nurses
“The past three years dramatically transformed our industry and workforce in ways that accelerated the modernization of care,” said Providence SVP and System Chief Nursing Officer Sylvain Trepanier, RN, in the news release. “Co-Caring represents an innovative solution to one of healthcare’s most pressing issues—the increased need for nurses, which for the United States is currently estimated at more than 200,000 new nurses required each year to account for population growth.”
The roots of the Co-Caring model were created by nurses for nurses. Under the Co-Caring initiative, a support team of certified nursing assistants (CNAs), patient care technicians (PCTs) and nurse technicians (NTs) perform routine functions, reducing demand on nurses.
“By creating a new team that would share responsibility and accountability with a nurse that would be working virtually, we have people showing up every day doing the work that they love to do and removing some of the barriers that they had in doing it the old traditional way,” Trepanier told the Catholic Health Association of the United States (CHAUSA).
“Quite frankly, when we embraced this, even if we could cover our costs and it would be cost neutral, it would be a great proposition,” he continued. “The pleasant surprise of this is that we’re elevating the practice of nurses, the technicians feel a part of the team, and the patients are having a good experience. We’re having great operational outcomes and decreasing the total cost of care.”
Virtual Nurses
Virtual nurses are utilized through a bi-directional audio/video telehealth platform to support the bedside team in caring for patients. These virtual nurses assist with tasks like admission processes, discharge preparation, pre-procedural checklists, and medication reconciliation. Interdisciplinary Team Meetings, which include the virtual nurses alongside charge nurses, physicians, and case managers, are held daily to ensure the best patient care.
The Co-Caring model increased patient and caregiver satisfaction while simultaneously having positive financial significance. The first-year turnover rate (FYTO) among registered nurses decreased by 73% and by 55% for all staff involved in the program. Covenant was also able to decrease the amount of travel nurses it needed, which enabled it to hire more nurses, CNAs, and PCTs.
“On a 30-bed unit, we ended up having a return on our investment of roughly $450,000,” Trepanier told CHAUSA. “Our patients are happier, our nurses are happier, and we’re decreasing our total cost of care, which is what everyone should be after.
“If we don’t do this, we are going to run out of time in healthcare,” he continued. “I recognize that not everyone has the resources and not everyone has the capability of pulling something off like that. I also am very cognizant that the status quo is not an option. For the sake of our patients and for the sake of the health of the communities that we serve, we all need to lean in and figure out how to approach the work differently.”
Lessons for Clinical Laboratories
This innovative approach identifies which tasks need to be performed by skilled individuals and which can be done by lesser qualified personnel. Tasks are then assigned accordingly. Clinical laboratories may be able to take advantage of similar types of opportunities.
By reorganizing workflows, pathologists and clinical laboratory scientists could devote their time to higher value tasks, while the lesser tasks could be performed by pathology assistants. At a time when the number of laboratory professionals appears to be decreasing, it is imperative that lab managers develop ways to operate labs more efficiently.
—JP Schlingman
Related Information:
Covenant Medical Center, a Providence Affiliate, Revolutionizes the Way Nurses Deliver Care
Co-Caring Uses Virtual Nurses to Help Caregivers and Patients
Hybrid Nursing Model Expands Following Successful Pilot
Providence to Expand Co-Caring Model That Adds Virtual Nurses to the Team