JMIR Publications

ABSTRACT

Background:

Over the past decade, the adoption of virtual wards has surged. Virtual wards aim to prevent unnecessary hospital admissions, expedite home discharge, and enhance patient satisfaction, particularly beneficial for the elderly population who face risks associated with hospitalization. Consequently, substantial investments are being made in virtual rehabilitation wards, despite evidence of varying success in their implementation. However, the facilitators and barriers experienced by virtual ward staff for the rapid implementation of these innovative care models remain poorly understood.

Objective:

This paper presents insights from hospital staff working on an Australian Virtual Rehabilitation Ward (VRW) in response to the growing demand for programs aimed at preventing hospital admissions. We explore staff's perspectives on the facilitators and barriers of the VRW, shedding light on service setup and delivery.

Methods:

Qualitative interviews were conducted with 21 virtual rehabilitation ward staff using the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework. The analysis of data was performed using Framework Analysis.

Results:

Managing certain conditions, especially those involving comorbidities and sociocultural factors, can be challenging. The VRW demonstrated suitability for technologically engaged patients without cognitive impairment, offering advantages in clinical decision-making through remote monitoring and video calls. However, interoperability issues and equipment malfunctions caused staff frustration, highlighting the importance of promptly addressing technical challenges. The VRW empowered patients to choose their care location, extending access to care for rural communities and enabling home-based treatment for older adults. Despite these benefits, the cultural shift from in-person to remote treatment introduced uncertainties in workflows, professional responsibilities, resource allocation, and intake processes. As the service evolves, ongoing adaptation is crucial, with a need to refine technical aspects and carefully consider the shifting burden of care to patients and their families.

Conclusions:

In this qualitative study exploring healthcare staff's experience of an innovative VRW we identified several drivers and challenges to implementation and acceptability. The findings have implications for future services considering implementing VRW for older adults in terms of service set-up and delivery. Future work will focus on assessing patient and carer experiences of the VRW. Clinical Trial: N/A