A new virtual support model of care introduced as a clinical deterioration safety net in rural and remote hospitals is to be evaluated for its impact on patient outcomes.
The Western NSW Local Health District’s (WNSWLHD) vCare Virtual Support model of care was introduced in 2019, an additional function within its existing vCare service.
It allows remote clinicians to recognise clinical deterioration and guide management as an extension of its rural and remote clinical teams.
Virtual Support was specifically designed to provide an additional safety net for patients in 35 WNSWLHD rural and remote hospitals where failure to recognise and provide timely management of clinical deterioration was a contributing factor to several serious incidents.
“Delayed or failure to recognise, and timely respond to clinical deterioration as per the ‘Between the Flags’ system and delayed referrals to vCare for transfer to a higher level of care of critically ill patients were key reasons for introducing vCare Virtual Support service,” said Amanda Hunter, General Manager of vCare in WNSWLHD.
Prior to the introduction of the vCare Virtual Support service, rural clinicians solely relied on a one-way self-referral to vCare service to escalate or refer their patients requiring higher level of care than health resources locally available.
This could mean delayed referrals, delayed transfers or missed treatment opportunities to provide the right care at the right time and avoid unnecessary patient harm.
Evaluation
The effectiveness of the vCare Virtual Support model of care will be evaluated in a new project coordinated by the Digital Health Cooperative Research Centre (DHCRC) along with the University of Sydney’s School of Rural Health and Menzies Centre for Health Policy and Economics.
WNSWLHD is one of the largest LHD’s in New South Wales, covering 250,000km2 and a population of approximately 276,000 people.
The virtual service helps to overcome the tyranny of distance by incorporating improved clinical escalation and communication pathways, and advanced remote monitoring utilising alerts and algorithms for clinical decision support by the team of dedicated virtual care clinicians, Ms Hunter said.
“With a 24/7 dedicated team, the virtual care model allows us to have an additional set of eyes and ears supporting patients with advanced virtual care and remote monitoring technology across rural and remote facilities,” she said.
The project seeks to generate new evidence on remote monitoring systems in rural and remote healthcare settings by evaluating the patient, family and carer expectations with virtual care, as well as clinician experiences and the impact on patient outcomes.
The evaluation will also include the economic implications of the service including use and sustainability of resources, compared to traditional care.
“This will help us to understand both patient and clinician experiences of this new model of care and how virtual care programs, such as this one, can contribute to a more equitable and sustainable healthcare system, potentially, enhancing statewide rapid response systems, and ultimately advancing the quality of care delivered in rural and remote settings,” said DHCRC CEO Annette Schmiede.
Main image: Western Virtual Division vCare HUB in Dubbo. The Virtual Support workstation is in the foreground working amongst the rest of the team and core functions of the service.
