Maximizing Patient Care and Efficiency Understanding the True ROI of Virtual Nursing
Virtual nursing is often seen as a way to reduce workload, but it’s more about reallocating time effectively rather than saving minutes. For example, by handling admissions, discharges, or other routine tasks, virtual nurses allow bedside staff to focus on in-person care that requires their immediate attention. This isn’t about giving nurses more free time—it’s about prioritizing tasks to improve patient outcomes.
A key advantage of virtual nursing is its potential to streamline the discharge process, allowing patients to leave the hospital sooner. Virtual nurses can ensure discharge instructions are given promptly, reducing delays and improving patient satisfaction. Moreover, responding to call bells and triaging issues remotely can lead to faster interventions, which patients and families value immensely.
The real benefit of virtual nursing lies in its ability to improve hospital throughput and patient care without overburdening staff. It’s not about drowning in three feet versus 10 feet of water—it’s about finding ways to stay afloat and deliver better results for patients and hospitals alike.
Listen to Holly Lorenz, Narinder Singh, and Tiffany Wyatt explore virtual nursing’s return on investment.
Video Transcript
Narinder Singh:
I want to talk about the other part of this, which is the money part. So we do some pilots, you do some pilot industry is doing pilots, they get some results, but usually some of these things take a very long time to measure increasing efficiency or satisfaction. How does that turn into retention or care? If you were thinking about like, look, I believe in the potential of virtual nursing, I need to generate evidence and need to generate evidence in a way that gets the CFO and COO on board about systemic change after we’ve had the success with a unit or a hospital. How would you look at these categories of others to try to build that case to say we need system level change?
Holly Lorenz:
Well, let’s start with the first one that you’ve mentioned, the create efficiencies. I think one of the things that I would never do is to suggest to any CFO that if we were to start to do admission and discharges, let’s use that as an example because it’s really something people understand quite well. As a virtual nurse, then I can reduce 30 minutes of workload from a nurse and I’m going to save that time. There is a large amount of work on any given day that gets prioritized intentionally. And so what it does allow is the prioritization to actually remove two things in the day or three or four wherever you are. So the efficiencies really are how I can focus on the things that need someone that’s there in person to manage. And yeah, it might take away an hour and a half of work that I did the day before, but let me assure you, there isn’t any nurse or caregiver that’s going to say, you know what? Now there’s another hour and a half that I don’t have to do anything. That’s not it. We are able to really focus our attention on where the needs are for that day. And so it’s not treating things as equitable or exchange of minutes, but it’s really being able to more appropriately individualize the care that needs for patients because we’ve been able to remove some work from a nurse or a caregiver’s day.
Narinder Singh:
We’ll hit the other categories, but I want to push back a little bit on that because a fun part of our discussions. So sitting in my mom’s room for a thousand hours over 12 weeks, I definitely appreciated when nurses were available versus they weren’t. You think in that context, your patient, your loved one is the center of your universe. So that side of me appreciates what you said. At the same time, I think even in past paradigms, how do you deal with the fact that you have two of your hospitals, they both have one to five, one to six, but one of them has all sorts of support services that support the nurse and the other one doesn’t. So they’re not doing the same unit of work work and of course the CFO at some point’s like, okay, how are we paying for this? How do we explain that delta even aside from virtual nursing, how have you thought about support services and what the right ratio is? I know it’s a third rail topic, that’s why I’m tossing it over to you to help us think about where efficiency comes from and when it’s time to translate it into changes in things that are toxic like ratio versus let it make for better prioritization of care.
Holly Lorenz:
Well, to be efficient, you need to have the right person, the right type of care person at the right time, who has the right amount of time to devote to give the right care. And the more that we can make that an easier solution because some things are being removed from the care environment to a virtual setting, the more efficient we’re going to be. I’m also going to suggest that any patient that we can tee up having a more complete admission assessment or a more timely admission assessment or even one that is discharge related allows us to probably send someone home earlier. Getting someone out of bed is going to send someone home earlier that allows patients should be in the hospital when they need the care to be in the hospital and having someone even delayed at the end of their stay as they’re getting ready to home, go home when all that patient is waiting for is discharge instructions and it takes hours because the nurses or whoever is the person designated to discharging people can’t get to it leaves a very negative lasting impression as someone’s leaving the hospital. So that feeds into this increasing the satisfaction, even the discharge process can be improved with virtual nursing and as a result increased satisfaction if indeed your virtual nurses answering call bells,
That instantaneous response is priceless to a patient or a family member. And knowing that that’s getting escalated to the right caregiver so that they can intervene and take action is really a positive thing. I totally believe that patients and family members don’t necessarily care who’s responding. They care more that someone responded.
Narinder Singh:
Yeah, I mean you hit such a couple very profound points. I think as you were talking, the thing that came to mind for me was that a lot of times it’s attractive for the CFO and me and the county and me to talk about the numbers like this. And the real analogy is we’ve got a lot of nurses who are underwater and you’re like, Hey, do you want to be two feet underwater or 10 feet underwater? And the point is it doesn’t matter. You’re underwater at that point. And I think what we’re seeing is if we can create the right structure and measurement, the piece is not that we make you further down or further up and drowning, it’s that we’re resulting in better outcomes for patients, albeit they’re harder to manage. Throughput matters to hospital finances, patient satisfaction, HCAP scores matter, care metrics matter to everybody because of both costs and the like. And I think it’s like, hey, if we can better allocate the time, we have a real opportunity to actually create an ROI based on those versus trying to decide if we’re going to drown in three foot of water or 30 feet of water.
Holly Lorenz:
Yeah, I have never heard a nurse say that as a result of virtual nursing, I’ve had to work harder. And if they did say that, I would question the way in which they’ve deployed their virtual nursing team. So we need to think about that too. Right.
Narinder Singh:
I think one thing you hit that I think is even beyond the scope of the last slide but really kind of resonated is on the discussion of alarms. I remember in my one example, my masters at UCSF was in alarm fatigue, which you two are experienced from actually having to deal with it at the bedside. And it’s like something like 99 5% of alarms are false, but then somebody’s got to go be on the phone or walk down to the room and you can see the opportunity cost of that. And I remember it’s very personal because I remember the SPO two cuff slipping off my mom’s finger several times a day, but the pattern of that alarm sounds exactly the same as when the pipe from the trach slips out of her neck. And one of those is obviously if you’re there and looking at it, what’s an emergency and what’s meaningless, but from outside the room, you’re just dealing with another alarm that’s false 95% of the time.
And so I do think there’s some real opportunities for thinking about how we think about care redesign to kind of make us all effective in a way that does satisfy both the CFO the patient and the day-to-day experience of the nurse. It’s not an impossible mission if we can think about using some things that we’ll talk about in a second