The Virtual Nurse: Adding Value to the Perioperative Experience
Laura Hollis, MSN, RN, CCRN; Julie Hamm, MSN, ACNP-BC; Kristy Bishop, ADN, RN3
Vanderbilt University Medical Center
BACKGROUND
PROCESS OF IMPLEMENTATION
IMPLICATIONS
Due to high surgical volume in an academic
medical center, there were continuous challenges
with the optimization of surgical patients. The
need to touch more patients for anesthesia
preparation created an opportunity for innovative
strategies to add value to the organization and the
patient experience. Innovative technology was
crucial to assist in the assessment of patient
information and quickly communicate regarding
appointments, current medications, plan of care,
and medical history.
A multidisciplinary team worked to devise a program pilot proving feasibility to have an RN call
American Society of Anesthesiology Physical Status Classification (ASA Class) 1 & 2 patients
preoperatively. A Nurse Practitioner (NP) conducted the pilot and showed success.
The RN position was hired and the program began looking to touch more patients and add value to day
of surgery preparedness. An additional RN FTE and two PRN RN positions were hired to facilitate
this work.
A Clinical Lead NP role was developed to review cases with RNs, act as a liaison with the
anesthesiologists, and serve as a resource, mentor, and educator.
Several technologies have been incorporated into these roles to provide an immediate view of the
information for real time decision making.
Patient preparation with the use of preoperative
RN “virtual” visits adds a level of convenience
for patients, eliminates patient clinic wait time,
cost of getting to a clinic visit, as well as
improves day of surgery flow and downtime
within the perioperative system. This work has
also shown improved satisfaction and quality
for patients, physicians, and staff.
RN VOLUME
PURPOSE
Utilize nurse (RN) callers to optimize the patient
experience and satisfaction with the use of a
“virtual” phone call option for the preoperative
anesthesia evaluation as well as add value to other
aspects of the perioperative arena.
Optimizing patient records reduces time spent day
of surgery seeking information, additional patient
testing, and decreases risk of cancellation.
RN Volume
350
300
250
200
150
100
50
0
July
August
September
October
November
December
January
February
March
April
May
June
July
August
September
Volume steadily increasing with onboarding staff. Patient and Staff satisfaction/engagement vital to success.
TECHNOLOGIES
OBJECTIVE
Create RN positions that would complete
“virtual” appointments using technology to
facilitate pertinent patient information for
anesthesia providers in order to add value to the
patient experience and optimize perioperative
patient movement on the day of surgery.
CONCLUSION
To optimize the patient experience and add
value to perioperative system, the role of the
RN caller has been developed and
incorporated
to provide current patient
information and medication reconciliation
preoperatively
without
an
in-person
appointment. Retrieval of outside records and
other pertinent information allows for
improved patient preparation for day of
surgery. This role has increased perioperative
efficiency and productivity as well as created
an opportunity to reach more patients that
previous efforts allowed.
Technology has improved communication with
patients as well as within the clinic and
organization.
Growth and development of this program has
expanded the number of FTEs as well as
provided an opportunity for growth and
development of nursing staff.
REFERENCES
LYNC application through Outlook, along with Clinic Whiteboard and Message Basket applications within StarPanel, create real
time data streaming enhancing communication and situational awareness thus increasing productivity.
Vanderbilt Preoperative Evaluation Center website. (2014).
https://vandypoint.mc.vanderbilt.edu/sites/anesthesiology/VPEC/SitePages/Home.aspx