After organizations identify and greenlight an opportunity to shift a service to a new site or modality, the last step is embedding and launching the new pathway. Rather than adding a virtual alternative to an in-person service, which would duplicate access points and increase costs, West Moreton instead works with clinical teams to reconfigure existing in-person pathways to become either fully virtual or hybrid pathways, depending on the proposed care model. This ensures that all new models are sustainable and scalable.
The process of reworking existing care models is a collaborative effort between the Virtual Support Team and the clinicians on the unit where the care shift is happening. Involving clinicians in the process of embedding new pathways is critical to securing buy-in and maintaining their engagement.
Repetition strengthens site-of-care shift skills and minimizes variation within care models
The Virtual Support Team follows the same codified set of steps for every care shift and new model they implement. Again, this is an effort to both reduce variation across their services and strengthen the skill set of the Virtual Support Team through repetition.
1. Secure buy-in with descriptive, not prescriptive, data
For every care shift, the Virtual Support Team first secures buy-in from the clinical team by presenting data that highlights inefficiencies in the clinical team’s current processes, such as long wait times and referral backlogs. The goal of this step is to get clinical staff on the same page and highlight the problem at hand and the opportunity to deliver better, more efficient care for patients—not to push a specific agenda that is solution-focused from the start. This approach ensures that clinicians don’t feel like change is being imposed on them.
2. “Unpack” the current workflow’s inefficiencies
The next step in the process is unearthing the root causes of the inefficiencies highlighted in step one. To do this, the Virtual Support Team breaks down the clinical team’s current workflows and conducts an in-depth root-cause analysis.
For example, in their virtual chronic disease management program for heart failure patients, the Virtual Support Team dissected clinical workflows and uncovered inefficiencies. The analysis revealed a lack of adequate staffing resources to meet rising demand, a lack of alignment to strategic priorities, inaccessibility of patient data, outdated technology, and other issues.
3. Collaboratively “repackage” new workflows
Once teams understand why current in-person processes are inefficient, they can create new virtual and hybrid workflows that solve for those root-cause problems. Collaboration between the Virtual Support Team and clinicians is especially critical in this step to ensure that the clinicians embrace the changes. To that end, the new model is staffed with clinicians’ preferences in mind. Clinicians who prefer to deliver in-person care continue to do so, while those with an affinity for virtual care operate the virtual pathway.
In the disease management program for heart failure patients mentioned above, the Virtual Support Team and clinical teams embedded new remote monitoring technologies and remapped nursing team hours under new hybrid in-person/virtual pathways to maximize efficiency. This enabled the clinical team to deliver care to more patients and do so even faster.
4. Start small and scale over time
Lastly, the Virtual Support Team and clinicians launch the new model. At first, clinicians see the same number of patients they saw under the in-person-only model so they can become accustomed to the new model. Gradually, the number of patients under each clinician increases.
West Moreton HHS has launched seven virtual chronic disease management programs (outlined under the first bullet on page 6) following the steps outlined in this section. This approach can be replicated to other site-of-care-shifts, not just in-person to virtual.
Following a templatized process for launching new care models reduces variation across new programs and builds on lessons learned. By repeating these four steps for every care shift, the Virtual Support Team is mastering their skills and consistently improving West Moreton HHS’s ability to respond to sustainability threats.