We will discuss how a virtual nursing team can support an organization’s efforts to enhance patient safety and reduce risk in the face of patient surges, work stoppages, and staff turnover. Demonstrate how we used clinician engagement and measures of care efficiency to identify gaps in care and remediate them through an interactive and actionable data source. Discuss the importance of leadership engagement and clinician buy-in in collaborating across disciplines, identifying barriers, developing interventions, designing new processes, and adapting solutions over time. Embracing the five principles of High Reliability to help healthcare organizations adapt to an ever-changing care delivery environment.
Problem: The ongoing patient surges together with staffing shortages, leadership, staff turnover, and work stoppages, have created significant gaps in care. These gaps can compromise patient safety and quality of care and increase the chances of regulatory findings during surveys.
Measurement:The virtual nurse leverages EMR dashboards for real-time monitoring of care gaps. If any care gaps are identified, the virtual nurse promptly alerts designated hospital personnel for immediate remediation. The action is logged in MIDAS, which can be accessed via Tableau. Tableau-generates run charts and disseminated at each medical center.
Analysis: We conducted a comprehensive analysis to identify the prevalence of care gaps within our healthcare system; sedation care gaps accounted for 77% of all care gaps. We compared the post-intervention data with the baseline data, which resulted in a significant 50% improvement in addressing sedation care gaps.
Implementation: We observed some variation in how care gaps were being addressed and identified a need for follow-up. We developed a standardized communication process between the virtual nurse and the hospital to follow up with the clinicians in real time to modify the order. Leaders receive daily care gap summary reports.
Results/Discussion; The virtual team incorporated standardized communication tools and TeamStepps principles of situation monitoring, leadership, and mutual support. Ongoing efforts are being made to modify regional policies on sedation, vasopressors, pain, and delirium management. These changes have improved hospital throughput, compliance with regulations and standards, and certification surveys.
