Lyndon Helen, Viney Tracey, Slade Vicki
University of Plymouth, South West Clinical School, Drake Circus, Plymouth, Devon, PL4 8AA, UK.
Cornwall Partnership NHS Foundation Trust, Digital Health Service, Bodmin, Carew House, Beacon Technology Park, Dunmere Road, Bodmin, PL31 2QN, Cornwall, UK.
Oxf Open Digit Health. 2025 Apr 14;3:oqaf008. doi: 10.1093/oodh/oqaf008. eCollection 2025.
This service evaluation provides an overview of the virtual ward model in Cornwall, UK, and was implemented using the Consolidated Framework for Implementation Research (CFIR). Interviews were conducted with virtual ward patients and clinicians and analysed using thematic analysis. A virtual ward is a digitally enabled service enabling people requiring hospital-level care to receive that care at home, either as an alternative to hospital admission or by facilitating an earlier discharge. Four themes emerged from the data: (i) Readiness for change: the virtual ward service was not embedded in existing health provision with scepticism and reluctance to refer to the virtual ward. (ii) Confidence and trust: due to system incompatibility issues, clinicians lost confidence and trust in the remote monitoring system; however, patients had high levels of trust in the virtual ward staff, increasing their confidence to remain at home. (iii) Digital challenges: using the monitoring equipment was challenging for some patients with issues of digital exclusion including understanding the technology and connection difficulties. (iv) Impact: despite the challenges, the virtual ward was highly valued by patients and supports person-centred care, offering a safe alternative to hospital admission. Virtual wards in Cornwall were rapidly implemented leading to some implementation barriers; nonetheless, the overwhelming response from patients demonstrated how they valued the virtual ward as a viable alternative to hospital admission and how the compassion and professionalism shown by the virtual ward clinicians made them feel safe and supported in their own homes.
本服务评估概述了英国康沃尔郡的虚拟病房模式,并使用实施研究综合框架(CFIR)进行实施。对虚拟病房的患者和临床医生进行了访谈,并采用主题分析法进行分析。虚拟病房是一项数字化服务,使需要医院级护理的人能够在家中接受护理,既可以作为住院的替代方案,也可以促进更早出院。数据中出现了四个主题:(i)变革准备:虚拟病房服务未融入现有的医疗服务中,存在怀疑态度且不愿转诊至虚拟病房。(ii)信心与信任:由于系统不兼容问题,临床医生对远程监测系统失去信心和信任;然而,患者对虚拟病房工作人员高度信任,增强了他们留在家中的信心。(iii)数字挑战:对于一些存在数字排斥问题的患者,包括理解技术和连接困难,使用监测设备具有挑战性。(iv)影响:尽管存在挑战,但虚拟病房受到患者的高度重视,并支持以患者为中心的护理,提供了一种安全的住院替代方案。康沃尔郡的虚拟病房迅速实施,导致了一些实施障碍;尽管如此,患者的压倒性反馈表明了他们如何重视虚拟病房作为住院的可行替代方案,以及虚拟病房临床医生所展现的同情心和专业精神如何让他们在自己家中感到安全和得到支持。