Issue link: https://beckershealthcare.uberflip.com/i/1524413
12 EXECUTIVE BRIEFING EXECUTIVE BRIEFING 1 N ationwide, healthcare leaders are recognizing the value of incorporating virtual nursing into service lines that have historically followed direct care models. Virtual nursing is a logical response to widespread health system challenges, such as high vacancy and turnover rates among registered nurses, hospital capacity shortages, the untenable cost of hiring agency workers, and unresolved RN burnout. To learn more about the benefi ts of virtual nursing and how to deploy this innovative care model effectively, Becker's Healthcare recently spoke with two experts from Banyan Medical Solutions: Tony Buda, founder and CEO, and Carol Boston-Fleischhauer, MSN, RN, senior vice president and chief clinical offi cer. Reducing workload intensity for direct-care staff, while improving patient throughput During the COVID-19 pandemic and beyond, many healthcare organizations turned to virtual nursing as a strategy to keep beds open, stabilize their permanent workforce, mitigate the unsustainable cost of agency and travel nurses, and address stressful working conditions. According to Ms. Boston-Fleischhauer, the clinical workforce challenges that emerged during the pandemic are starting to stabilize; in particular, some turnover reduction. Still, the inpatient work environment remains extremely stressful. Key contributors include higher patient acuity levels, continued staffi ng shortages in many markets, and time consuming care needs that aggravate RN burnout. "In 2024, there are more registered nurses in the workforce; but fewer of them want to work in acute care," Ms. Boston-Fleischhauer said. "We've had a 10-year decline in registered nurses interested in inpatient employment. Virtual nursing can support the work environment for permanent registered nurses by reducing their workload intensity and providing them the support they need." In the post-COVID era, both patient volumes and lengths of stay are on the rise. As a result, capacity at hospitals and health systems is at a premium and emergency department boarding has become a signifi cant problem. "Many health systems are embracing virtual nursing as a primary strategy for improving throughput and decreasing length of stay; creating more capacity and revenue potential" Ms. Boston- Fleischhauer said. Virtual nursing is also a market differentiator for organizations looking to recruit direct-care clinical staff; in particular, novice RNs looking for additional organizational support as they transition from academia into practice. "Working at the top of licenses is a big deal for registered nurses, but it can be elusive," Ms. Boston-Fleischhauer said. "Organizations use virtual nurses to assume time-consuming work that does not require direct patient contact; this provides direct care RNs the time they need to practice at the top of their license. The result? An improved work environment and dramatically decreased RN turnover levels." Traditionally, most healthcare organizations have looked to virtual nurses to take on documentation-heavy responsibilities such as admissions and discharges. Now, hospitals and health systems are getting excited about other clinical work that could be optimized with virtual nursing. Examples include patient rounding, focused patient education, 24-hour chart checks, structured mentorship of novice nursing staff and more. "Another area where virtual nursing is exploding outside of the acute care setting is in the emergency department," Ms. Boston-Fleischhauer said. "Opportunities exist for virtual staff to initiate select care for ED patients being admitted; including admissions and rounding, while waiting for an inpatient bed to become available. The result? ED RNs rely on the virtual nurses to assume that work, while the ED nurses prioritize their time with patients requiring ED RN skills and expertise. Decreases in inpatient LOS and associated operational costs also occur. Virtual nurses can support accelerated discharges as well." Looking ahead, Ms. Boston-Fleischhauer noted it's only a matter of time before organizations use virtual nurses as they move patients to transitional care services; including skilled nursing facilities or home health, as well as the growing trend of organizations offering the hospital-at-home model. More than a technology solution to workforce challenges Although interest in virtual nursing is growing fast, no clear industry standard or defi nition exists for how to deliver care in this way. "I would still call virtual nursing the Wild Wild West — we haven't yet landed on the gold standard," Ms. Boston-Fleischhauer said. "As a result, organizations across the country are trying to fi gure out how to leverage virtual care for patients and families, but they don't have a lot of clarity about how it is defi ned, let alone how to design the model to achieve the outcomes that are needed; be they workforce quality, safety, patient experience, or fi nancial." Based on nearly a decade of experience in virtual nursing, Banyan Medical Solutions takes a fundamentally different approach to optimize model design and sustainability. "From the start, we understood that successful virtual nursing involves more than just technology. It's about overcoming the roadblocks in staffi ng and implementation to make it truly sustainable," Mr. Buda said. Ms. Boston-Fleischhauer reiterated this point, noting the role of technology in Banyan's broader strategy and aims. "We view virtual nursing as a care model innovation that optimizes virtual communication technology," Ms. Boston-Fleischhauer said. This approach, she said, requires a service strategy based on three core components. Banyan Medical Solutions leverages a comprehensive, virtual communication technology platform to connect direct-care staff, virtual staff, and patients and families in the patient room. This platform is intentionally designed to support the appropriate types of communication and visual capabilities needed for virtual care. 'More than just technology': How virtual nursing models are shaping care delivery innovation