By Erin Langmead, MBA, MSN, RN-BC, and Cassandra E. Tyransky, RN, BSN, CCRN
The nursing profession is in crisis, amid staffing shortages, burnout, and resignations, prompting many health systems to seek alternative approaches to care delivery to maintain high-quality patient care.
WellSpan Health, an eight-hospital health system based in Pennsylvania, was experiencing many of the challenges facing other hospitals across the nation, including rising staffing costs, resignations of clinical staff, turnover, and narrowing margins.
To overcome these barriers, WellSpan piloted a smart hospital platform powered by artificial intelligence, which enabled our health system to reduce provider burden, increase patient and nurse satisfaction, and improve financial results.
Snapshot of a profession in turmoil
Although nurses have long served as the foundation of the U.S. healthcare system, the profession is at a crossroads in the wake of the COVID-19 pandemic, which brought massive levels of stress and burnout for nurses, while simultaneously causing staffing issues and cost surges for health systems. As a nurse and health system leader, I understand the urgency of solving this problem for both clinicians and hospitals.
Unfortunately, the nursing crisis may get worse before it gets better. By 2026, the demand for nurses will have grown by 15% at the same time the industry is facing “serious personnel shortages across the field,” according to the Professional Research Consultants (PRC) National Nursing Engagement Report.
Often, staffing shortages contribute to burnout, as nurses are asked to take on additional administrative job responsibilities without receiving more time to accomplish these new tasks. Burnout, in turn, drives a lack of engagement, which may lead to staff dissatisfaction, increased turnover, and escalating staffing costs for hospitals.
The PRC report illustrates this trend, noting that only 45% of nurses feel fully engaged in their jobs, meaning they are emotionally and intellectually connected to their hospitals, with more than 14% feeling unengaged. Further, nearly 20% of nurses working in emergency department settings were unengaged, while millennials had the highest percentage of unengaged nurses (17.1%) of any age group.
For health systems, the financial impact of staffing shortages and a lack of staff engagement may be significant when factoring in costs associated with termination, a reduction in team productivity, recruiting, and training. During periods of high staff turnover, diminished morale and disrupted job duties become “the norm,” according to the report.
Better care through virtual nursing and patient monitoring
The COVID-19 pandemic created substantial staffing difficulties for WellSpan and hospitals across the country, as overworked and stressed-out nurses retired, quit, or sought other lines of work. We knew that the solution to the staffing crisis did not simply involve hiring more people to replace people; we needed to take advantage of advanced technology and artificial intelligence (AI) to support nurses and help them re-engage with their passion: patient care.
Accordingly, we implemented a smart hospital platform to enable virtual patient monitoring and virtual nursing. The pilot hospital’s first use case of the platform was to reduce falls among at-risk patients by using AI-enabled technology to detect the occurrence of these incidents. Although early in the pilot, we are already starting to see a decrease in patient falls while reducing the use of costly one-to-one sitters, which the hospital employed in its prior approach to fall detection and prevention. We are also seeing a synergistic interaction, as the virtual monitor is actively cross-monitoring the bedside team to ensure in-room safety plans are in place (such as bed alarms). This has enhanced teamwork and professional confidence, as they are able to give and accept real-time feedback, in the name of patient safety.
Additionally, the smart platform has enabled WellSpan to launch a virtual nursing model, utilizing in-room audio and video connections. Virtual staff located within a control room at the facility can interact with patients and request assistance from on-site clinicians when needed. This approach ensures the patient is always being monitored while allowing clinicians to focus on direct patient care, alleviating staffing challenges.
The technology includes AI-driven sensors, computer vision, voice recognition, vital sign monitoring, indoor positioning capabilities, and actionable analytics reports that—when coupled with deep learning and open integration standards—streamlines safe patient care and reduces clinician burden. The platform is electronic health record and hardware agnostic, enabling it to seamlessly integrate into existing technology, ensuring consistent data-sharing among different systems.
Since adoption, nurse satisfaction has risen because the system augments nurses’ expertise and reach, enabling them to directly serve patients while offloading additional documentation burdens to their virtual counterparts.
In a short period of time, we have seen increased interest due to the flexibility in practice that nurses are desiring. They can share their clinical expertise virtually, while finding relief from a physically-taxing 12-hour shift. Similarly, patients have been pleased with the program because it enables bedside staff to focus on their care, while they also receive heightened attention provided by the in-room monitoring and virtual nurse. Further, WellSpan has seen cost savings from the investment associated with decreased sitter usage, reduction of overtime, and utilization of light-duty nurses.
Staffing and associated cost issues for health systems are likely to persist into the future, making it imperative that hospitals innovate to discover new approaches to solving the same problems. WellSpan Health is making significant strides to address these long-standing issues with an AI-driven smart hospital platform that utilizes algorithms based on our unique needs. Thanks to the true impact this technology has made, we plan to expand the program into additional use cases (such as improving throughput) and hospitals in the near future. This scalability is critical as we look to solve these issues systemwide.
Erin Langmead, MBA, MSN, RN-BC, is Interim Director of Clinical Informatics and Physician Informatics Support and Cassandra E. Tyransky, RN, BSN, CCRN, is Nurse Manager, Acute Inpatient Rehabilitation Unit, at WellSpan Health.