Pugmire Juliana, Ashish Abdul, Chadwick Alison, Wilkes Matt, Meekin Daniel, Zaniello Ben, Zahradka Nicole
Best Buy Health Inc., Boston, MA, USA.
Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK.
J Prim Care Community Health. 2025 Jan-Dec;16:21501319251326750. doi: 10.1177/21501319251326750. Epub 2025 Mar 20.
The Wrightington, Wigan, and Leigh NHS Teaching Hospitals Foundation Trust (WWL) developed a novel virtual ward (VW) service that integrated with community and primary care, supported healthcare throughout a patient's journey, and had a clinical workflow that could step-up or step-down care as needed. We described their VW and evaluated clinical outcomes, adherence, safety, and patient satisfaction.
Retrospective, single-center study of patients admitted to the WWL VW service from January 14, 2022 to January 31, 2024. Clinical data collected by WWL in their database for patients admitted to the VW, were matched to data captured automatically by the Current Health (CH) platform linked to the CH remote monitoring kits assigned to patients on the VW. The CH kits enabled the VW care at WWL and included a wearable device for continuous vital signs monitoring, a blood pressure cuff, and tablet. Evaluation metrics included clinical scope, clinical outcomes, adherence, safety, and patient satisfaction.
There were 1835 admissions and a 93% match rate between the clinical and CH databases. About 38% of referrals were step-up (31% ambulatory care and 7% primary care) and 62% of referrals were step-down (100% inpatients). Most specialty referrals were from thoracic and acute medicine (77%). The median length of stay on the VW was 8 days [IQR 5-13], 209 (12%) admissions were escalated to the hospital, 179 (11%) escalated to the emergency department out of hours, and 29 (2%) signposted to urgent medical services. Adherence to the wearable device was 92%. There were 38 minor safety incidents (typically hypersensitivity reactions or administrative errors) and 17 expected deaths. About 94% of admissions rated the VW experience as "excellent" or "good." Results were similar between step-up and step-down referrals.
We have shown the VW service yielded acceptable clinical outcomes, was safe with no serious adverse events or negative impact on mortality rate. Patient adherence to the technology and satisfaction with the VW service were high. The VW service was innovative in its acceptance of a broad range of patients, expanding services beyond respiratory medicine, and in developing a step-up pathway, preventing some patients from ever taking up an acute bed in the hospital.
赖廷顿、维根和利国民保健服务教学医院基金会信托机构（WWL）开发了一种新型虚拟病房（VW）服务，该服务与社区和初级保健相结合，在患者的整个就医过程中提供医疗支持，并且拥有一种可根据需要加强或减弱护理的临床工作流程。我们描述了他们的虚拟病房并评估了临床结果、依从性、安全性和患者满意度。
对2022年1月14日至2024年1月31日入住WWL虚拟病房服务的患者进行回顾性单中心研究。WWL在其数据库中为入住虚拟病房的患者收集的临床数据，与通过Current Health（CH）平台自动获取的数据进行匹配，该平台与分配给虚拟病房患者的CH远程监测套件相连。CH套件实现了WWL的虚拟病房护理，包括一个用于持续生命体征监测的可穿戴设备、一个血压袖带和一台平板电脑。评估指标包括临床范围、临床结果、依从性、安全性和患者满意度。
共有1835例入院病例，临床数据库和CH数据库的匹配率为93%。约38%的转诊是加强护理（31%为门诊护理，7%为初级护理），62%的转诊是减弱护理（100%为住院患者）。大多数专科转诊来自胸科和急症医学（77%）。虚拟病房的中位住院时间为8天[四分位间距5 - 13]，209例（12%）入院病例被升级到医院，179例（11%）在非工作时间被升级到急诊科，29例（2%）被引导至紧急医疗服务机构。可穿戴设备的依从率为92%。发生了38起轻微安全事件（通常为过敏反应或管理失误）和17例预期死亡。约94%的入院患者将虚拟病房体验评为“优秀”或“良好”。加强护理和减弱护理转诊的结果相似。
我们已经表明，虚拟病房服务产生了可接受的临床结果，是安全的，没有严重不良事件或对死亡率产生负面影响。患者对该技术的依从性和对虚拟病房服务的满意度很高。虚拟病房服务在接纳广泛患者群体、将服务扩展到呼吸医学以外领域以及开发加强护理途径以防止一些患者占用医院急性病床方面具有创新性。
