Amid an influx of patients and extreme occupational burnout, Providence's Covenant Medical Center in Lubbock, Texas, piloted a virtual nursing model in 2021. Years later, the system has proven the model's value as it garners retention, length-of-stay and safety achievements.
"I was walking the floors at that time, and it was rough," said Cynthia Salisbury, MSN, RN, Providence's executive director of nursing operations. "Moral distress is the word that comes to me. Looking at our nurses that were working on the floor at that time, they were exhausted."
About three years later, virtual nursing has reintroduced joy into nursing care at Providence, Ms. Salisbury said.
At the Renton, Wash.-based system, virtual nurses assist in-person care teams with administrative tasks including admissions, discharges, preprocedural checklists and medication reconciliation. The program, called the Co-Caring model, is active in med-surg units and will soon expand into oncology units, emergency departments and postpartum units. The system is also exploring its use in the pharmacy department.
Ten of Providence's 51 hospitals have implemented the model. By the end of January 2025, another five hospitals will feature these units, and by the end of first quarter in 2025, an additional 12 will adopt them.
During the piloting phase, there was a 50% reduction in turnover in one unit, and early indicators show substantially reduced turnover in Co-Caring units. The system has also scored wins in reducing length of stay and the rate of catheter-associated urinary tract infections.
The time to discharge — or the time between a physician writing a discharge order and the patient's discharge — is between 22 and 35 minutes shorter in Co-Caring units compared to other units. This equates to a 4.9% decrease in length of stay.
It's difficult to draw a direct line between the virtual nursing model and these results since the organization has implemented several methods to decrease length of stay, Ms. Salisbury told Becker's.
"Can I say that some of the drastic drops we are seeing in length of stay on the units with Co-Caring, that it is completely, 100% due to the Co-Caring model?" Ms. Salisbury said. "No, I cannot say that, but when I look at what the model today is aimed at [and the expectation of a discharge taking two hours or less], many of our Co-Caring units are exceeding that. They are meeting that and exceeding it."
For CAUTIs, the standardized infection ratio is 0.44 in Co-Caring units, while the system's median SIR is 0.74.
Ms. Salisbury said one of the most rewarding benefits has been strengthening the nurse-patient relationship.
"There is nothing like the reward that you get from serving a patient," she said. "It fills my cup, even that little interaction that I get. So what we want for our nurses, we want for their cups to be filled every day that they're serving at the bedside. We're really looking at Co-Caring as a solution to bringing that reward back."