Could telehealth be the solution for the nursing shortage in hospitals? Jefferson Health thinks so

Bazz Jarjous didn’t go to nursing school to type notes into charts. He would rather spend time with his patients, but administrative tasks take up most of the Abington Hospital nurse’s day.

Earlier this year, Jarjous had the opportunity to help develop a potential solution. He participated in a virtual-nursing pilot program at the Jefferson Health-owned hospital: Bedside nurses were paired with a remote nurse who assisted via telehealth. From a computer station away from the unit, he would handle the administrative work of interviewing patients at admission, typing notes, and ordering medications from the pharmacy.

Even though not the most glamorous tasks for a nurse, he found the experience rewarding. Because he didn’t have to manage the direct care of five other patients, Jarjous could take time with the patients he spoke with through a screen. He felt like a valuable team member.

“I really felt helpful,” he said.

Jefferson Health leaders say patients and staff members gave the virtual-nursing pilot high marks. At a time when hospital nurses are in short supply and burnout rates are high in the profession, the concept centering on a mobile telehealth station being wheeled from room to room could be part of the solution.

And Jefferson found it could cut down significantly on a major hospital expense: staffing.

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Telehealth has long been touted as a solution for many ailments of the American health-care system, with the potential to expand access to care in rural areas, reduce costs, and make care delivery more convenient. The COVID-19 pandemic accelerated the adoption of virtual health care, as regulators temporarily relaxed rules to allow providers to prescribe medications that previously required inpatient visits.

The Jefferson pilot explored how telehealth could address a staffing challenge. Roughly 30% of direct-care nursing positions in Pennsylvania hospitals are vacant, according to a 2022 survey by the Hospital and Healthsystem Association of Pennsylvania. As hospitals struggle to recruit and retain nurses, a major grievance cited by nurses is burnout due to having too many patients under their care.

The virtual nursing pilot at Jefferson’s Abington Hospital ran from March to June. More than 20 cameras were spread through two “med/surg” units where patients are preparing for surgery or recovering from a procedure. When a bedside nurse needed help with an admission or discharge, answering patients questions, or taking notes, they’d call in the virtual nurse.

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For the health system, that’s cheaper than having two nurses at the bedside, said Colleen Mallozzi, senior vice president and chief nursing informatics officer at Jefferson. And patients end up waiting for a shorter period of time to get discharged.

She noted the normal nursing ratio on the unit is five or six patients to each nurse. One virtual nurse was able to see 30.

“They can cover a much wider breadth of patients,” she said.

An additional benefit of virtual nursing is that it offers an alternative job, without leaving patient care, for nurses who need a break from the bedside, she said.

Other hospitals across the country also reported positive experiences with virtual nursing, including in New Jersey. An article on the website of the American Hospital Association, a trade group for the hospital industry, touts virtual nursing as an alternative to the traditional model of only-bedside nursing, which they call unsustainable due to a projected shortage of nurses.

Groups advocating for nurses also see the potential of virtual nursing but caution that telehealth should only be used to support bedside nurses, not replace them.

“Virtual nurses should never be used to decrease the number of nurses at the bedside,” said Wayne Reich, the CEO of the Pennsylvania State Nurses Association, via email.

Moving forward, Jefferson is looking to launch a larger pilot that will include additional responsibility for the virtual nurses, such as safety observations for patients at risk for falls. While some staff were initially apprehensive, Mallozzi said that most had accepted the model by the time the pilot was over.

“This is one where there’s not a lot of eye rolls, which is a good feeling,” she said.