Virtual Ward
About this good practice
International and national research informed the decision taken by the Health Service Executive (HSE – responsible for the provision of health care in Ireland) to pilot virtual wards in Ireland. A virtual ward is where patients due to their medical circumstances would normally be treated in hospitals but are treated in their own home in the community instead. The patient is treated by a multi-disciplinary team including a case manager, nurse, occupational therapist and physiotherapist. The virtual ward provides on average two weeks of follow-up care in the community following hospital discharge. The service is offered to patients over 75 years old who are within 6kms of St.Finbarrs Hospital (pilot hospital) in Cork in the Southern region of Ireland. Once a patient is referred to the multi-disciplinary team, patients are followed up within 24 hours in their own home. The service is overseen by a consultant who meet the multi-disciplinary team once a week. The main beneficiaries of this good practice is the patients and their families. The policy is to roll out this service in primary care centres across the country. Staff have found that they needed to build confidence in the service which has taken a lot of time but are now operating at full capacity. The service needs to be adequately funded by the HSE to enable this successful service to grow. The virtual ward targets the dependent and fragile SilverSME groups.
Resources needed
Currently, the service supports 4 FTEs and one part-time support physio. The staff are based in St.Finbarrs hospital which includes a meeting room for a team approach to patient care. Equipment and medical supplies for patient care are available to the multi-disciplinary team.
Evidence of success
Since its inception, the number of patients the virtual ward treats increased (2016 – 100, 2017 – 137, 2018 – 263). Within the last year, only 2.3% of patients were readmitted to hospital following integrated care in the home and 42% of their patients who presented at a Hospital Emergency Department, were referred to the integrated care team and avoided hospital admission. The service is now operating at full capacity and they plan on hiring 2 additional FTEs, so the service can be expanded.
Potential for learning or transfer
This successful service and if resourced, has the potential to generate significant savings for the Irish health service. There has been a reduction in hospital readmission's and the ‘silo effect’ has been removed with a team approach to patient centered care. It currently costs approximately €839 for an in-patient bed per night in an Irish hospital. It is well documented in the research that hospital patient stays are more expensive than if the patient is treated in the community generating savings for the health service. Since the service began, documentation has reduced and staff have streamlined processes so relevant documentation is available at all times to the multi-disciplinary team. The Virtual Ward has potential benefits for older people and their families who live in rural Ireland and is an example of a good practice, which has the potential for transfer across European regions. The lessons learned will help other international providers in the delivery of this service
Good practice owner
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Virtual Ward