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Transforming Models of Care Through Comprehensive Hospital-Wide Virtual-Integrated Nursing Practice and Collaborative
Ashley M Carlucci1, Jennifer Carpenter, Brian Nelson
1Author Affiliations: Chief Nurse Executive, Allegheny Health Network, Pittsburgh, PA (Carlucci), Chief Nursing Officer, University Hospitals (UH) MacDonald Women's Hospital, UH Rainbow Babies & Children's Hospital, System Chief Nursing Informatics Officer, Cleveland, OH (Carpenter), Program Manager, UH Veale Initiative for Health Care Innovation, Cleveland, OH (Nelson), Chief Nursing Officer, UH Lake West Medical Center, Willoughby, OH (Stachnik), Platform Lead, UH Veale Initiative for Health Care Innovation, Cleveland, OH (Yanus).
Objective:
To evaluate the impact of implementing a hospital-wide virtual-integrated nursing care model on teamwork, communication, operational efficiency, and clinical outcomes.
Background:
Organizations have implemented virtual nursing to improve workflow efficiency and patient outcomes. Yet variation in care models, inconsistent role definitions, and a limited leadership infrastructure have left organizations struggling to achieve consistent, measurable outcomes after adopting virtual care.
Methods:
This mixed-methods quality improvement study employed the TeamSTEPPS® survey across acute inpatient, intensive care, and emergency settings. The study also analyzed operational, quality, and workforce outcomes measures to evaluate the impact of the intervention on virtual nursing.
Results:
A significant improvement was observed in the supervisor/manager's behavior pre-model and post-model implementation (P=0.022). Improvement in operational outcomes included gains in patient admission documentation, discharge timeliness, and falls reduction, and staffing efficiency without the addition of full-time equivalent staff.
Conclusions:
Hospital-wide virtual-integrated nursing improved workflow efficiency, enhanced operational outcomes, and demonstrated a scalable model for clinical outcomes.
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