A service evaluation of virtual wards in Cornwall, UK

TL;DR

This study evaluates virtual wards in Cornwall, UK, showing they offer hospital-level care at home but face challenges like digital issues and clinician skepticism.

Contribution

The study provides a novel evaluation of virtual wards using the CFIR framework and thematic analysis of patient and clinician perspectives.

Findings

Virtual wards were highly valued by patients as a safe alternative to hospital admission.

Clinicians faced system incompatibility issues that reduced their confidence in the remote monitoring system.

Digital challenges, including equipment use and connectivity, affected some patients' experiences.

Abstract

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.

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