Virtual wards enable patients to be discharged home while still under the care of the specialist clinical team.
The Docobo remote monitoring solution, DOC@HOME® is being used to monitor children who have been discharged from hospital but require a level of monitoring to maintain their safety at home.
Paediatric virtual wards are an essential tool in managing the anticipated increase of children being admitted into high dependency care, as well as managing the flow from acute trusts.
How do teams prepare for roll out?
Graphnet works collaboratively with clinicians or nursing teams and consultant paediatricians to set up remote monitoring within paediatric services.
Graphnet helps create specific question sets, based on consistent information required about a child’s condition (e.g. HSP, nephrotic, jaundice, gastroenteritis, bronchiolitis & respiratory). When completed, this information is shared with clinical team.
The team also engage with patients and their families, observing and actioning improvements based on their feedback.
How virtual wards work
Monitoring patients on a virtual ward enables the patient to safely remain in their home environment while regularly sending, and digitally storing, necessary data to the specialist clinical team, it can also allow patients to leave hospital sooner rather than later, freeing up a bed for another child.
- Suitable patients for paediatric virtual ward monitoring are identified within the ward round, using specific criteria and a multi-disciplinary risk assessment
- Parents/ guardians of the patient are fully informed about virtual ward monitoring and given the opportunity to discuss any concerns or objections. Informed consent is obtained prior to admitting a child to the virtual ward
- A referral form is completed to inform the virtual team and ensure all relevant information has been considered and effectively liaised
- Patients are enrolled on the programme. Parents/ guardians are given training and demonstrations, ensuring they are confident with obtaining physical observations as well as how to use the technology prior to commencing remote monitoring for their child. As well as training videos are available on the device
- Parents/ guardians are responsible for completing the relevant question sets whilst their child is at home. Data is completed on a smart device which is immediately accessible to all monitoring clinicians of the virtual ward
- Monitoring patients on a virtual ward enables the patient to safely remain in their home environment while regularly sending, and digitally storing, necessary data to the specialist clinical team. Alerts are set to ensure that any results outside of expected parameters are immediately highlighted to the team – alerts, interventions, outcomes and notes are all digitally recorded
Question sets are scheduled to be completed within specific windows throughout the day, while 24-hour access to the paediatric telephone support remains available for any time it may be required. Parents/ guardians receive regular telephone contact from their specialist team to discuss any concerns and to review the child and relevance of the virtual ward service. When discharge from the virtual ward has been agreed, the equipment is collected and returned to the hospital, where it is appropriately sanitised and made available to other patients.
Benefits
There are a wide range of benefits for patients and families using the virtual ward service, including:
- Reduced length of stay in hospital – children and young people can safely return to their homes earlier
- Early evidence has suggested there is also a marked reduction in risk of in-patient re-admission after discharge from the virtual ward
- Children and young people can reside in their own homes with the people who know and care for them best while continuing to receive specialist support – which offers a far better patient experience
- Peace of mind for parents/ guardians and families – specialist clinical support remains accessible throughout the virtual ward process. Should any result be outside of the patients’ usual parameters, parents/ guardians will quickly receive a telephone call to from their specialist team to discuss
- Reduces anxiety – enabling care to be less intrusive for the child’s usual lifestyle, and for the parents/ guardians who have additional responsibilities to maintain (such as work, other children etc)
- Continuity of care for children and young people.
- The child being more comfortable in familiar surroundings and the parent being able to maintain their routine
- Both the child and parent being less stressed than they were or would be in hospital surroundings – including benefits for eating (child) and sleeping (child and parent, with poor parental sleep associated with having a child on the inpatient ward).
- The parent(s) being able to care for the child’s sibling where there was another child in the family unit
- Clinical Hours Released
Hospital benefits
There are also a range of benefits for healthcare providers:
- Reduced bed days
- Increased capacity and flow
- Reduction in time spent on ward rounds
- Reduced amount of follow-up visits post discharge
- Reduced readmissions to emergency services or paediatric wards
- Enables team to increase capacity for better case management and prioritising of the most vulnerable
- Increased staff morale by supporting the delivery of better patient care and experience
What do the virtual wards monitor?
Symptoms and signs, including:
- Blood Pressure
- Pulse
- SpO2
- Respiration rate
- Temperature
These will be determined on the child or young person’s condition.
Adrian Flowerday, Managing Director at Docobo says:
We are so impressed with the way teams are working with the Docobo virtual ward technology to create such benefits for children and young people. The team have been great at picking up and running with the solution, enabling more children and young people to be monitored and given the best care.
