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Implementation of Virtual Clinical Emergency Response Team Model: Impact on Response Timeliness and Reliability
Background:
Delays in Clinical Emergency Response Team (CERT) workflows and variability in post-event practices contribute to impaired response timeliness and documentation practices. Hybrid virtual-in-person response models may offer a feasible approach to improve response timeliness and reliability of post-event practices.
Methods:
The authors conducted a retrospective, single-center, pre-post quasi-experimental study evaluating a virtual CERT (vCERT) program that leveraged in-room audiovisual technology to enable immediate virtual response by a nurse practitioner (NP). Implementation occurred through a phased rollout-phase 1 (August 4, 2025; weekday day shifts) and phase 2 (September 29, 2025; expansion to 24/7 coverage). The study included 2,854 CERT activations between January 1 and December 31, 2025. The primary outcome was time to first NP contact, either in-person or virtual. Secondary outcomes included documentation compliance for post-event debriefs (structured team discussions immediately following an event) and four-hour follow-ups (scheduled reassessments four hours after an event). Outcomes were compared pre- and postimplementation.
Results:
In the postimplementation period, 80.4% (952/1,184) of all activations used the vCERT program. Median time to first NP contact decreased by 90.3%, from 3.50 minutes (IQR 2.86-4.22) preimplementation to 0.34 minutes (IQR 0.28-0.41) postimplementation (p < 0.001). Post-event debrief documentation compliance increased from 43.3% to 70.6% (p < 0.001), and four-hour follow-up documentation compliance increased from 10.1% to 26.6% (p < 0.001).
Conclusion:
This pre-post evaluation of a hybrid virtual-in-person emergency response model was associated with significant improvements in response timeliness and reliability of post-event activities. Collectively, these findings suggest that the vCERT model is feasible and may serve as an augmentation, rather than a replacement, of bedside care. Future studies should investigate the impact of such models on patient outcomes.
