Latest / Becker’s Healthcare Podcast / How Virtual Nursing Is Reshaping Med Surge Care at The Christ Hospital

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How Virtual Nursing Is Reshaping Med Surge Care at The Christ Hospital · Becker’s Healthcare Podcast

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  Every year, Becker's annual meeting brings health care
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  leaders together to unpack the most pressing issues
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  healthcare executives will return to Chicago
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  Join us April 13 through the sixteenth.
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  For the agenda and event details, visit beckershospitalreview.com
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  and click on the events tab in the
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  upper right.
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  This is Laura Dierda with the Becker's Healthcare
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  podcast. I'm thrilled today to be joined by
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  Julie Holt, chief nursing officer and vice president
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  of patient care services, and Paula Campbell,
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  chief nursing information officer at the Christ Hospital
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  Health Network.
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  Julie, Paula, thank you so much for joining
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  us on the podcast today.
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  Thank you for having us.
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  Absolutely. Now I'm excited for our conversation and
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  to learn more about some of the cool
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  things that you're doing on the technology side,
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  the patient care side, and your perspective on
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  the future. But before we dive in, can
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  you tell us a little bit more about
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  yourself as well as the Christ Hospital Health
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  Network?
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  Absolutely.
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  I'm Julie Holt. I'm the chief nursing officer
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  here. I've been with our organization for about
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  eleven years,
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  and I'm a native of Cincinnati
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  and,
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  very excited to be here and talk about
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  some of the innovative things that we're doing.
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  And I am Paula Campbell. I'm the chief
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  nursing information officer. I work very closely with
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  TwinFold
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  and IT in general.
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  I have been, with the organization
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  since 2016
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  in this role. But prior to that, I
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  started my nursing career there at Price Trust.
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  So I am also a native assistant.
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  Yeah.
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  Awesome. Amazing to hear. I mean, you must
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  have, just deep roots within the Cincinnati area,
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  and then to be able to serve the
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  community and give back, in the health care
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  space in such a meaningful way, I can
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  imagine, is,
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  you know, really, critical and something that is
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  very special,
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  for you and your organization. So that's amazing
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  to hear.
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  I'm curious, Julie, what can you talk a
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  little bit about,
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  the most important initiative that you led in
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  the last year? What did you do, and
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  what were the results?
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  Absolutely.
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  So the Christ Hospital Health Network is,
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  the smallest network in the Cincinnati region, but
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  we do have one quaternary care hospital in
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  the downtown area that's we were 500 plus
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  beds. And
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  the pandemic in Cincinnati hit hard, like many
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  areas of the country,
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  and
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  we, you know, suffer suffered through some of
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  the workforce challenges
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  that many institutions,
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  experienced.
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  So,
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  last year,
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  well, it actually started the year before that.
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  We started planning on, you know, how can
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  we deliver the same level of exceptional care
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  to the community
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  if we don't have the same number of
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  RNs
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  available
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  as the literature might indicate.
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  And we started exploring how technology could help
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  us with that, and we settled on,
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  creating a virtual
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  model within our med surge
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  units,
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  to help augment,
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  the care delivery there to basically change the
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  care delivery model,
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  because
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  although we've been fortunate like, we're not as
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  hard hit as I think some areas and
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  our actually is back down to pre pandemic
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  levels in our vacancy.
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  We just know that
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  the research shows that there's gonna be a
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  significant nursing shortage in the future. Nurses are
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  not going to be there.
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  The community and the the patient population is
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  aging as well as nurses.
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  So we thought now is the time
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  to come up with a new care delivery
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  model to help support
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  med surg delivery, particularly since that's been an
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  area nationally where I think we've all struggled
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  with staffing.
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  Yeah. I, again, I think it it was
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  just really an opportunity
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  for us to be in the forefront of,
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  you know, a delivery model care change.
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  As an organization,
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  we have remote ICU support Yeah. Since 2008
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  and also been, you know, kind of a
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  leader in the market for that space. So
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  this was just an opportunity to expand.
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  That sounds like an amazing idea, and what
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  a great project to, really make sure you're
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  expanding the access to care for the community.
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  It's something that's so important and critical right
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  now. And, you know, as you both mentioned,
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  looking at how the population is shifting
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  and what really the community needs today,
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  is important to have that kind of flexibility
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  and and build,
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  the type of hospital care model that's going
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  to work best. Now looking ahead, what are
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  some of the biggest priorities and headwinds that
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  you're focused on for 2026? And, you know,
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  I'd love to hear from you on on
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  this one, Paula.
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  Yeah. So, I really I think before we
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  get started and talk about the future, maybe
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  Julie
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  provide a little feedback on what we've learned
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  and kind of the results that we've seen,
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  and then we can talk about
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  where we get from here. Right. So as
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  far as the virtual care model, it's on
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  three of our med surg units.
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  And what we are doing is,
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  augmenting
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  the bedside care with two virtual nurses for
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  approximately a 30 bed unit. Our units are
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  anywhere between 29
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  28 to 30 beds.
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  Those nurses,
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  are experienced nurses. We hired them with experience
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  on purpose. They went through a very specific
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  orientation,
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  and, we've had working teams determining what the
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  workflow
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  the workflow is for the virtual nurses versus
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  the bedside
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  very positive for us.
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  We've been able to fill positions that were
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  open for many, many years through the pandemic.
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  We
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  have been able to,
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  better refine some of our safety prevention processes
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  at the bedside, like bed alarms and
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  fall prevention,
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  things like that to better hardwire,
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  things that need to be done, like four
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  eyes and four hours, things like that.
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  And to really,
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  for our new graduates, we wanted to see
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  a decrease in our,
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  first year turnover, which is another national problem.
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  And we have seen that as well because
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  these experienced nurses are there and able to
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  help mentor them. So, overall,
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  very positive,
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  results for our first year. So and now
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  I'll turn it over to follow on.
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  Yeah. So where do we go from here?
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  So as Julie alluded to, we're on three
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  of our med surg units. So, really, our
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  goal over the next year or so would
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  be to continue to expand that amount of
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  care to the rest of our med surg
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  units
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  and also our step down units. Again, another
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  area that's beginning to really feel the crunch
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  of a really high acuity patient,
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  as well as, you know, some turnover
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  and just, you know, the complexities.
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  So we really wanna expand in that space.
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  Another area might be women's health. We are
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  growing significantly in that space, and that is
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  a skill set that that really does take
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  a long time to develop, but also really
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  hurts the backs of nurses. So any of
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  these nurses that we can retain into a
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  virtual,
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  nurse platform to support these new grads is
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  really where we're headed.
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  And then I guess the other thing that
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  we're doing is, you know, how do we
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  optimize that technology?
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  So can we expand this to other disciplines
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  such as our anesthesiologists
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  who are doing pre op visits,
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  our case managers who are doing discharge planning,
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  our diabetes educators? We can make them much
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  more efficient,
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  by being able to have those conversations with
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  patients and see patients,
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  without really traveling throughout campus.
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  And then then finally, we would look to,
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  really, again, continue to optimize that technology
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  by using that technology
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  for telecity.
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  So if you think about it, we have
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  85,
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  cameras in rooms,
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  that we can immediately turn on for telecity.
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  That is just unbelievable. That would actually increase
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  our fleet of being able to deliver telecity
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  by 500%.
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  So when you think about that investment, that's
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  really where we're hoping to expand.
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  So we're excited about the future. We're excited
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  about what our partners are doing and really
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  how the software is evolving with the needs
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  of the organization. And
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  so we're looking to see, can we be
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  a beta site for some of these things
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  as well? Yeah.
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  That's really cool to hear. And, you know,
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  it's amazing to think about how the technology
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  has expanded capabilities and really the ability to
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  provide
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  safer care and and additional,
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  services and support for patients as well as
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  the nurses on the front lines.
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  I I think it's just so cool to
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  hear you both talk about some of these
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  different projects and and opportunities moving forward.
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  I'm curious as well. What do you think
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  the hardest thing you'll have to do in
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  the next year will be?
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  No. I think the hardest thing is,
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  expanding the funding in the way that we
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  need it. The technology does
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  cost money. It's not outrageously
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  expensive, but it costs money. And
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  I think a lot of times when you're
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  taking these things forward as a CNO, you
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  know, everyone wants an ROI on it and
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  to show, like, where are you going to
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  save. And,
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  we had hoped for that, and we did
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  see some savings
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  in our agent experienced agency nurses over into
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  these virtual roles at regular pay. So that
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  was great. But now that that's done,
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  the the savings
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  per se is not there. It's more of
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  a soft ROI from a quality,
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  perspective from the reduction of turnover,
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  from being able to expand you know, reduce
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  your vacancy because you're expanding the the work
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  years for nurses who may be older and
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  not able to,
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  take care of patients anymore at the bedside,
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  but we wanna keep their brain engaged and
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  those kinds of things. So there's soft
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  ROI, but it's hard sometimes to put, specific
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  dollars to it. It's not unlike, you know,
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  there's a big trend,
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  with,
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  the voice
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  recognition
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  software of our documenting. I think one of
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  the vendors is Ambien.
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  Again, there's a cost for that technology. It
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  improves the efficiency in the care delivery, but
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  there's not a lot of savings
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  in it. So I think that's gonna be
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  a challenge, not just for us, but for
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  health care in general as we look at
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  changing these models of care. You know, how
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  do we,
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  how do we pay for this? How do
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  we we incorporate it into the model,
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  And how do we,
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  quantify,
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  you know, the value? Yeah. It really it
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  really becomes a a cost avoidance at this
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  stage of the game. You know, there are
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  periods where you're implementing these technologies
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  where you do have a savings.
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  You know, it's on sitters and that sort
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  of thing or, you know, the turnover.
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  But, you know, as the future goes, it
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  becomes more possible.
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  Right?
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  I see. I I think that makes a
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  lot of sense and, you know, to look
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  at,
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  any kind of initiative today. I know dollars
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  in health care are very valuable, and so
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  to have that kind of
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  understanding of where the value is coming from
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  and then trying to figure out, you know,
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  what the resources are, and matching that,
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  can be critical.
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  Before we wrap up here, I'm curious. Where
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  do you see some of the best opportunities
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  for organizational growth?
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  Well, I'll I'll go from my perspective as
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  both a a nurse and, you know, someone
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  who's engaged in technology. And, you know, I
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  think one of our biggest struggles is really
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  how to what is our standard of care
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  and, you know, what is our nursing model?
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  And, you know,
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  that is something that nursing has struggled with
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  across the years for various reasons,
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  to, you know, really our whole practice of
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  nursing.
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  But at this stage of the game, we
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  really have to start engaging other ways to
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  do things smarter
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  efficiently.
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  And so, you know, expanding that delivery of
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  care model, not just within our organization, but
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  really nationwide, it becomes it has to become
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  a standard of practice.
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  And I think the other opportunity, at least
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  from my perspective, is I go back to,
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  you know, what are we teaching at the
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  colleges?
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  How can we,
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  being experienced,
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  in this area, really influence that curriculum and
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  that model of care and that adoption of
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  technology
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  even before they graduate and become nurses so
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  that this is, like, such a big body
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  for us right now. Yeah. I think also
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  maybe not just our organization, but how do
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  we,
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  study what we're doing and studying what other
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  organizations are doing? There's a lot of different
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  variations on virtual care models now that are
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  out there,
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  and there's a lot more to do as
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  we talked about earlier. How do we,
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  we research that and make sure that we're
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  doing the right things in the the best
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  way,
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  because it's also new.
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  I would also say that,
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  I think every organization,
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  hospital should have a chief nursing informatics officer,
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  put a plug in for that. It surprises
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  me when I speak nationally how many organizations
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  do not have a chief nursing informatics officer.
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  For me, as as an experienced c and
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  o,
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  Paula is invaluable.
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  She is able to help me with the
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  strategic planning of nurse for our nursing practice
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  in the organization,
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  and,
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  to keep us, you know, in the
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  in what's on the cutting edge and what
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  what we can possibly do. It's
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  it's just extremely important,
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  and I would like to see that role
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  expanding,
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  throughout the country.
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  I love that. Being able to have such
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  a strong collaboration between the clinical care side
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  and the technology side and, you know, that
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  role of, bringing them both together, especially as
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  technology evolves so much and the needs and
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  health care are so great.
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  It seems like having that great advantage to
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  have somebody sitting at at the space between
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  them both makes a big difference.
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  Julie, Paula, thank you so much for joining
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  us on the podcast today. This has been
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  really fantastic conversation. I've learned a lot and,
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  you know, really inspiring to hear about some
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  of the things that you're doing at the
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  Christ Hospital Health Network. And I look forward
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  to seeing you both as well at our
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  annual meeting coming up in April. I know
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  you'll be speaking and and talking more about
• 14:42
  some of these things we talked about today,
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  and so I look forward to continuing the
• 14:46
  conversation.
• 14:47
  Great. Thank you so much for the opportunity,
• 14:49
  Laura.