CoxHealth’s virtual care team is something that Beth Polivka believes will be “the thing that you look back on and go, ‘that was the highlight of my entire career.’”
The senior vice president and system chief nursing officer at CoxHealth was part of the team that piloted the program in 2022, which uses technology to offer virtual support when patients are hospitalized in addition to bedside care. At its start, the virtual care team was limited to CoxHealth Springfield, but is now in the process of being implemented across the hospital system.
Since starting the program, the health care system has seen improved clinical outcomes and patient satisfaction with the virtual care team.
How the virtual care team works
The program was developed after Polivka and other hospital leaders went to a conference, where the topic of virtual nurses came up.
“The whole way home — (the conference) was out in Colorado — the whole way home, we were just talking and brainstorming,” Polivka said. The program was developed in nine days, and has evolved along the way.
Those concerned about a robot taking over their care need not worry — the virtual care team is not only staffed by humans off-site, but also designed to augment the care already provided by in-hospital clinicians. According to a press release, CoxHealth will maintain the same ratios for bedside nurses, with the virtual care team as additional support for them.
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When patients activate their call light, virtual care team members can respond quicker than bedside clinicians, allowing for people to receive care quicker. If something needs to be addressed in person, the team member will inform the bedside nurse, allowing the situation to be resolved in a more immediate matter.
State-of-the-art cameras allow virtual care team members to observe patients and the rooms they’re in, with such quality that the team members can look at oxygen flow meters, IV pumps or examine pupil dilation, according to Gina Ellerbee, administrative director of nursing practice and professional development. The virtual care team member will only observe a patient on camera when needed, like when a call light is pushed or a task is needed to be completed.
The system is adding this technology to every inpatient ICU and medical-surgical patient room at Cox South and Cox Medical Center Branson, and it is being added to mobile carts in Cox North, Meyer Orthopedic & Rehabilitation Hospital, Cox Monett and Cox Barton County, according to a press release.
Offering another layer of connection to patients
While Ellerbee was worried at first about patients feeling connected to virtual care team members, she was pleasantly surprised by the outcomes.
“What we’ve seen is that there may be more connection, because they have that person who has dedicated time — they don’t have eight other patients who are waiting for them, they don’t have all these other things that are weighing them down,” Ellerbee said. “They are 100% focused on that patient in the moment, and they get to know things about that patient, get to know them in that moment.”
To date, Polivka said, no patients have chosen to opt out of the program. She recounted feedback the program got from one gentleman: “Oh my goodness, can I take this home with me?”
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“It’s more than, ‘oh this is nice’, it’s ‘Oh, my word, how can I have more of this?’ Our patients have loved the way it’s not just an extra on the side, the virtual care team is changing the whole model of how care delivery is happening and it’s a win for the patients just as much as it is a win for the staff,” Polivka said.
The technology also allows patients’ families to better understand diagnoses or discharge instructions. Rather than relying on the patient or another family member to relay information from a bedside nurse to someone who comes in later, a virtual care team member can walk them through it again.
“Sometimes as a bedside nurse, the spouse comes in and visits, so you explain everything and walk someone through, then 30 minutes later, the son or the daughter shows up. They want to know, too. The virtual care nurse is helping fill that gap,” Polivka said.
Technology results in better outcomes for patients
While humans are still the ones making the decisions on every level of care, additional technology is helping those humans identify and flag issues before they happen.
At the command center, a team member has access to multiple screens with information relating to the patient, and algorithms can identify when a patient’s pulse or blood pressure might be trending in a way that indicates a problem.
“If (a bedside clinician) didn’t have the chance to open up the computer and plot a change, trend a change, that’s the beauty of the technology — It’s doing that part for you,” Ellerbee said.
The technology also allows for better communication between nurses in different departments. For example, the command center has med-surg nurses, who handle patients that may need a little less care, as well as ICU nurses, who handle patients who need more care. The virtual care team also has an early intervention team, composed of two experienced ICU nurses.
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Recently, Ellerbee explained, a med-surg nurse noticed a change in her patient that concerned her, but the nurse wasn’t sure what it was. The med-surg nurse consulted with one of the center’s ICU nurses, and ICU nurse sent the early intervention team to examine the patient.
“(They) prevented that patient from moving to the ICU; they were able to do what they needed to do in order to help. It prevented an ICU transfer or that patient deteriorating,” Ellerbee said. “That’s the best case scenario, and that’s what we hope would happen.”
‘Sky’s probably the limit’ for where program will go
Current plans to expand across the system will allow another level of care — a Springfield ICU doctor can virtually examine a patient who needs to be transferred to Springfield from Monett before the patient is even moved. The doctor can then more readily pick up on a change in the patient once they’re in Springfield, because they knew what the patient looked like a half hour prior.
“We can give that guidance and care, and you’re not even here yet,” Polivka said.
In the future, CoxHealth hopes to continue using the virtual care team, and even expand it — though future applications aren’t yet set in stone.
“The sky’s probably the limit is what we’ve learned from where we started, what we did in the pilot and what we actually did today. We’re doing way more than what we set out (to do),” Polivka said.
Susan Szuch is the health and public policy reporter for the Springfield News-Leader. Follow her on Twitter @szuchsm. Story idea? Email her at sszuch@gannett.com.