How Ardent Has Slashed Nurse Turnover at a Texas Health System
Key Highlights
- The virtual nursing pilot has led to a 6-point decrease in nurse turnover and cost savings per patient day while also improving hospital admission rates.
- Ardent is evaluating vendors to expand virtual care across its network.
- Future plans could include integrating more wearable devices and hospital-at-home models to further enhance quality and reduce costs.
Most health systems have been able to whittle down their spending on contract labor since the darkest days of the COVID-19 pandemic. What hasn’t improved nearly as much are the overall workforce pains many healthcare organizations face.
Nashville-based Ardent Health Inc. has scored a minor, yet promising, win—one that comes with the promise of much more—in its recruiting and retention efforts via a virtual nursing program at its East Texas division. The headline figure: Nurse turnover at the seven facilities involved in the pilot is down six percentage points from its trend of recent years.
Ardent, which runs 30 acute-care hospitals in six states, launched its pilot about a year ago by installing cameras in about 500 rooms across 14 med-surg nursing units. The partnership between teams led by Chief Nursing Officer Lisa Dolan and Chief Digital & Transformation Officer Anika Gardenhire built on several pilot programs that had identified the most promising use cases across the system.
Dolan said the program is structured to have 19 virtual nurses—most working from home—take on admission and discharge work that often keep bedside nurses from seeing other patients while also scheduling extra check-ins and handling patient education sessions. The typical virtual engagement, she said, lasts about 20 minutes.
The typical virtual nurse at Ardent has several years of experience, Dolan said, because they also work as “a pair of eyes in the sky” for newer nurses on the floor and help coach them through situations. Many of the latter, Dolan added, had limited exposure to clinical sites prior to starting work and often run into lots of new scenarios early in their careers that can lead to stress and burnout.
“It gives the nurses time back,” Dolan said of reducing bedside nurses’ administrative tasks. “But it’s also given them more time with patients, more quality time at the bedside.”
In addition to the improvement in turnover, Ardent executives say their operations are benefiting in other ways from virtual nursing. For instance:
- President and CEO Marty Bonick said at a recent Morgan Stanley conference that Ardent is saving $13 per patient day via its virtual nursing program. In addition to that financial boost, the company’s quality scores are benefiting, too, because it is using fewer contract workers who often need time to get up to speed.
- The virtual nursing program is partnered with a similar push involving attending physicians focused on cardiology, nephrology, pulmonology and neurology. “Doctors are very open to seeing patients like this,” Dolan said, adding that the technology gives them more time with patients because they’re not traveling between facilities.
- That in turn is flowing through to Ardent’s admissions statistics: The outlying hospitals in the company’s East Texas region have seen admissions climb about 11 percent since the virtual pilot started because they are being seen where they are and more often don’t need to be transferred.
Eyeing the next steps
The Ardent team is close to taking its next big step in its virtual strategy. Gardenhire said her team is aiming to decide by mid-November on a main vendor from the four Ardent has been testing so that it can significantly ramp up its virtual push. Guiding that process, she said, are both learnings about use cases where the company’s hospitals can make a true difference in patient care as well as the idea that it’s important to define the scope of Ardent’s virtual offerings.
Also important to consider in the decision-making, Gardenhire said, are a technical question and a very human one. On the one hand, she said, it’s important to consider the bandwidth needed to supersize virtual care. On the other, it’s also vital to ask, “How do we not lose our imagination?” as virtual care grows. Today’s technologies and/or prices may not work for what’s being considered but an ongoing partnership between clinicians, nurses and patients—one that views both of those latter groups as customers—can make future iterations better, Gardenhire said.
Ardent’s successes echo those of a similar program at American Family Children’s Hospital in Madison, Wisconsin. There, a virtual-care initiative in the neonatal intensive care unit lowered the turnover rate among nurses new to practice from 38 percent just a few years ago to zero since July of last year.
As Ardent prepares to expand the scope of its pilot across the company’s footprint, Dolan also is thinking about more tightly connecting virtual nursing to other elements of its work. From expanding the use of wearable devices to working a virtual element into hospital-at-home care, Dolan said there are many more opportunities to simultaneously improve quality and reduce costs.
“This technology is going to take us into whole new spaces,” she said.
About the Author
Geert De Lombaerde
A native of Belgium, Geert De Lombaerde has more than two decades of business journalism experience and writes about markets and economic trends for Endeavor Business Media publications Healthcare Innovation, IndustryWeek, FleetOwner, Oil & Gas Journal and T&D World. With a degree in journalism from the University of Missouri, he began his reporting career at the Business Courier in Cincinnati and later was managing editor and editor of the Nashville Business Journal. Most recently, he oversaw the online and print products of the Nashville Post for more than a decade and reported primarily on Middle Tennessee’s finance sector as well as many of its publicly traded companies.