AIMS
The evaluation will determine whether respiratory virtual wards, as compared to inpatient admissions, deliver better outcomes for patients through home treatment, improve the efficiency of hospital and community resource use, and enhance patient experience. The data and insights gained from the respiratory virtual ward experience will support the development of other virtual ward pathways, including those for frailty, heart failure, and diagnostics.
BACKGROUND
Patients with worsening chronic lung conditions often need to be admitted to the hospital for treatment with antibiotics, nebulisers, and close monitoring. However, the demand for hospital admissions exceeds capacity, creating a need for alternative care pathways. There is significant interest in safely managing these patients at home instead of in the hospital.
Research has shown that hospital admission can be associated with poor patient outcomes, including a loss of functional ability (reduced walking or independence), hospital-associated infections and falls. Research has also suggested that some patients can be managed at home with provision of treatment safely and have a better-quality experience of care.
NHS England has asked our hospital to develop virtual wards as a new care model, to care for people at home, rather than keep them in hospital. A virtual ward is where people are assessed during an acute hospital admission, and were deemed safe, are discharged home with medications, home monitoring devices (such as oxygen saturation readers) and have daily telephone calls with hospital staff to ensure they are recovering.
At UHB NHS Trust, we have developed a virtual ward for a chronic respiratory condition called COPD. Here, when patients are admitted to acute services, if they are deemed well enough, they are discharged and closely followed up on our “virtual ward.” However, we do not know if these virtual wards are effective or safe. Some patients are concerned about the safety of the virtual ward system, and healthcare professionals, patients, their carers, and NHS England all want to understand what the benefits and risks of the virtual ward system might be.
Using data from the electronic patient record, we aim to evaluate the COPD virtual ward system, to compare the outcomes for patients managed at home in the virtual ward compared with those who remained in hospital. This work will help decide if the virtual ward system is beneficial.
RESEARCH
The research aims to evaluate the respiratory virtual ward project to compare patient outcomes, resource usage, and patient experience with those of patients who receive traditional hospital care. The findings will help develop other virtual care pathways.
This project will also provide the learning for development of the second evaluation with commencement of the frailty, diagnostics, heart failure and surgical pathways.
PATIENT INVOLVEMENT
The researchers have engaged with patients with lung conditions and their carers on the development of the virtual ward pathway. They have also been involved in prioritising an assessment of the virtual ward system.
APPROVAL
This project was supported unanimously by the PIONEER Data Trust Committee.
This work is led by Dr Tanya Pankhurst, Chief Clinical Information Officer at University Hospitals Birmingham NHS Foundation Trust.
