TeleHospitalist providers triage according to urgency across the sites that they cover. The average time to begin a new admission was 45 minutes, with cross cover requests completed in about 10 minutes. Note that there is a degree of dependency in these times based on the availability of nurses at the partner site to bring the cart to the patient and act as Telepresenter during the admission.
Prior to going live with the TeleHospitalist service, our clinical leadership has extensive discovery conversations with the partner site to identify clinical pathways and determine what will work best for your staffing model and structure, and ensure that there is complete clarity around support for procedures. Each site is different, so the protocol agreed upon will be specific to what is appropriate at your facility. We do not go live without agreement on in-person support for procedures and code management.
The TeleHospitalist program supports the nursing team in a number of ways. Nursing staff at our partner sites have expressed appreciation for the increase in support offered by the program, in having quick access to a physician for cross-cover consultations, orders and admissions. Our TeleHospitalist providers are committed to building relationships with the onsite team and integrating into the team to the extent possible. Partner sites have also appreciated the Telepresenter training and opportunity for nurses to partner more closely with physicians on the H&P exam, viewing this as a development opportunity for their team.
If there is an intensive care service, TeleICU service or other providers onsite at night covering the ICU, roles, accountabilities and process for handoff will be determined in collaboration with the local team, based on facility resources and preferences, and appropriate acuity of the patient population.
Before going live with the TeleHospitalist service at any of our sites, the implementation team and clinical leadership meet with local leadership (nursing, hospitalists, specialties as appropriate) to ensure that the process for handoffs and communication is well established and agreed to by all teams. The TeleHospitalist team is able to suggest handoff procedures that typically work well, but as no two sites are the same, we are committed to working with your site on a process that is safe, reliable, and fits with your workflow.
At each partner site, we ask that a cohort of nurses be identified to participate in the program as Telepresenters. The Telepresenter training is a commitment of approximately 4 hours/nurse (~1 hour didactic and ~3 hours of skills), and covers the TeleHospitalist standard exam protocol and use of our platform and technology.