Carle Health Brings Technology and Virtual Inpatient Nursing to Allow for More Intentional Bedside Care

By Jill Dodaro, VP and CNO, Carle Health – Greater Peoria

The healthcare landscape is constantly evolving, with technological advancements offering opportunities to improve patient care and streamline workflows. At Carle Health, we’ve stepped into these opportunities to find modern solutions to serve patients. That affects our care team members in a variety of roles. In inpatient settings, the integration of telehealth represents a significant shift, impacting nursing care delivery. Contrary to initial assumptions of reduced hands-on care, the reality is more complex.

In 2021, our institution faced substantial staffing challenges, including high contract nurse utilization and elevated vacancy rates for Registered Nurses (RN) and Certified Nursing Assistants (CNAs). Simultaneously, experienced nurses were retiring rapidly due to the pandemic, diminishing valuable institutional knowledge, particularly during nights and weekends. Bedside nurses increasingly reported fatigue and feeling overwhelmed due to a growing shortage of ancillary staff, leading to an expansion of their responsibilities beyond traditional nursing duties.

Virtual Inpatient Nursing programs have enhanced our efficiency and patient engagement, allowing bedside nurses to focus on critical hands-on care.

Seeking solutions to alleviate this growing stress and workload, the Carle Health nursing leadership team observed the expansion of virtual healthcare in outpatient settings, primarily focusing on physician telehealth visits. However, virtual healthcare options for inpatient nursing were limited. While telehealth proved to be beneficial in expanding patient access to physicians, the question arose: how could it be optimized for acute care medical/surgical patient nursing needs within our hospitals?

To understand how nurses spend their time, our team conducted comprehensive inpatient nurse time studies. The findings indicated that new patient admissions, complex patient discharge documentation and education, and thorough chronic disease education were the most time-consuming direct patient care activities. Based on these findings, we proposed establishing a dedicated “Virtual Inpatient Nurse” (VIN) department. The primary objective was to strategically mitigate some of the identified workload burdens and associated risks faced by bedside nursing staff.

VINs needed to be highly experienced nurses capable of providing their extensive clinical knowledge and crucial empathy in a virtual environment. Carle Health is known for our compassionate nursing staff and the relationships we’ve built with our patients are core to our mission. To secure buy-in and build trust among bedside clinical nurses, leadership consistently emphasized that VINs were not intended to replace direct nursing care. Instead, the VIN role was presented as an evolution and enhancement of nursing care delivery, offering innovative opportunities to improve vigilance, operational efficiency, and ultimately, patient outcomes.

The strategic implementation of VINs allows bedside clinical nurses to prioritize their time and resources more effectively. By strategically offloading time-consuming yet critical tasks such as comprehensive new patient admissions, detailed patient discharge documentation and education, and in-depth chronic disease education, bedside nurses can focus more on patients at higher risk for complications or experiencing subtle deteriorations. This targeted approach enables them to concentrate direct, hands-on care on those with the most acute needs.

We are already seeing the impact of the VIN department and its potential to lead to a more equitable distribution of the overall nursing workload across inpatient units. It can improve team members’ experience by reducing fatigue and burnout among bedside nursing staff, which in turn could help retention rates. For instance, stable patients with well-managed chronic conditions can undergo admission, receive discharge instructions, and participate in detailed education sessions primarily through VIN. This frees up bedside nurses to dedicate more time and energy to acutely ill patients requiring more intensive interventions and direct physical care. In 2024, the VINs saved 3,123 hours from our bedside nurses, averaging 27 minutes per patient admission.

Furthermore, virtual inpatient nursing offers a unique opportunity to empower patients and their families to become more actively involved in the care process. Operating virtually allows the VIN to easily include geographically dispersed caregivers in important care planning discussions and crucial discharge education sessions. Without the immediate distractions of the busy bedside environment, the virtual nurse can provide undivided attention to the patient and their family, leading to an improved understanding of their condition and post-discharge plans. This increased engagement can significantly improve patient outcomes and a more supportive care experience.

However, the successful integration of virtual inpatient nursing care presents inherent challenges. Ensuring the absolute security of sensitive patient data and maintaining strict patient privacy are paramount. Robust technological systems and comprehensive organizational protocols must be rigorously implemented and continuously maintained to protect all patient information transmitted and stored virtually. Additionally, providing adequate and ongoing training and investing in readily available technical support are essential for all nurses to effectively utilize these new virtual tools to seamlessly integrate them into their workflows. Proactively addressing potential technological glitches and ensuring seamless interoperability between hospital systems are critical for successful and sustained operations.

Another crucial consideration is the potential for technology to inadvertently create a sense of distance or depersonalization in the fundamental patient-nurse interaction. Maintaining the essential human connection and empathy that form the foundation of nursing remains vital. At Carle Health, we view technology as a tool to enhance, not replace, the therapeutic relationship between nurses and patients. Ensuring all bedside and virtual nurses have dedicated time and opportunity for meaningful conversations, emotional support, and building strong therapeutic relationships remains paramount in an increasingly technological healthcare environment.

The evolution of telehealth and virtual nursing models will undoubtedly continue to shape inpatient nursing care. The key to successful and sustainable implementation lies in thoughtfully integrating these technologies to genuinely support and empower nurses, enhance patient safety and outcomes, and steadfastly preserve the irreplaceable human element of compassionate care. Virtual telehealth is not about replacing nurses but equipping them with advanced tools to provide more effective, efficient, and patient-centered care within the dynamic inpatient setting. The future of inpatient nursing will be characterized by a powerful synergy of technological innovation and the enduring power of compassionate human touch. We’re excited to be at the forefront of these evolutions to better reach patients and fulfill our mission of being a trusted healthcare partner to everyone we serve.