Dr. Erkan Hassan

Monthly Writings

Evaluations and reviews of the latest in the field.

Essentials for Effective Virtual Rounding

SUMMARY:

  • Virtual Rounding has applicability to support inpatient and outpatient models of care.

  • Virtual Rounds supports teams in EHR documentation, tracking tasks, supporting frontline clinicians and staff, helping to prevent burn out and serving as subject matter experts.

  • 4 Primary challenges along with essential solutions are known for Virtual Round process improvement.

BACKGROUND

  • The primary goal of virtual rounds is to support frontline clinical staff and ensure high quality care.

  • Care is provided to high need patients including inpatient (ward, ED, ICU) and outpatient settings.

  • Virtual Rounds can provide:

    • Direct virtual care delivery in emergent/urgent settings as well as ensuring the patient daily care plan is completed.

    • As needed (On Demand) clinical coverage.

    • Meeting discharge needs

    • Specialty consultations

  • Non-Rounding tasks include:

    • EHR documentation

    • Tasks to be accomplished (Things To Do)

    • Information gathering (Things To Know)

    • Follow up

    • Other support of frontline practitioners

    • Serve as subject matter experts

REVIEW:     

 4 NECESSARY DOMAINS FOR SUCCESSFUL VIRTUAL ROUNDS REVIEW:     



 1. Administrative:

MAIN PROBLEM: Discordant schedules among Virtual Rounders and Frontline clinical staff

 

ESSENTIAL COMPONENTS: 

  • Identify scheduling staff on Virtual and Frontline teams for regularly scheduled communications.

  • Team introductions ahead of time

 

2. Technical Challenges:

MAIN PROBLEM:  Variable audio/visual tools and quality; equipment maintenance; interoperability; other miscellaneous technical issues.

 

ESSENTIAL COMPONENTS:

  • IT support with regular communication

  • For inpatients pause between patients for team clinical summaries, questions and discussions.

 

3. ENGAGEMENT FROM FRONTLINE CLINICAL TEAM

 

MAIN PROBLEMS:

  • Frontline comfort with Virtual Team skill set

  • Expectation of tasks

 

ESSENTIAL TASKS:

  • Team introductions ahead of time

  • Jointly developed workflow expectations between Virtual and Frontline teams

  • Standardized introductions to providers and patients at beginning of session

  • Regular and ongoing communication between teams

  • Contextual Expectation Setting - Set expectations of duties and tasks

  • Virtual and Frontline Leadership managers biweekly check-in to build communication and continuity

 

4. TRAINING

 

MAIN PROBLEMS: Variability of specialties and EHRs by Virtual team

 

ESSENTIAL TASKS:

  • Virtual Rounding expectations

  • EHR(s) training

  • Develop training toolkit




CONCLUSIONS:

  • As telemedicine evolves, we are faced with a “new normal”.

  • Virtual Rounding can provide a valuable extension for frontline clinicians in the inpatient and outpatient setting.

  • The primary goal is always to improve care and ensure completion of each patients care plan along with early identification of potential deterioration.

  • Virtual Rounding presents a new set of previously unexperienced challenges.

  • By addressing these challenges along with essential approaches to optimization of Virtual Team integration are key to success.

Erkan Hassan