# Feasibility, safety and outcomes of a virtual ward with remote monitoring for patients awaiting urgent coronary artery bypass graft surgery

## TL;DR

A virtual ward with remote monitoring safely allows patients awaiting urgent heart surgery to stay home, reducing hospital bed use and improving patient experience.

## Contribution

Demonstrates the safety and feasibility of using a virtual ward with remote monitoring for patients waiting for urgent CABG surgery.

## Key findings

- No preoperative major adverse cardiovascular events occurred among 128 patients.
- The model saved an estimated 1152 inpatient bed-days and had a 95% patient satisfaction rate with home safety.
- Postoperative hospital stay was shorter than the national average, at 7.0 days versus 8.0 days.

## Abstract

Delays in performing urgent coronary artery bypass graft (CABG) surgery are increasing across the UK, with national wait times now exceeding guideline targets. Prolonged preoperative admissions contribute to hospital bed pressures, increased costs and negative psychosocial effects for patients. Virtual wards using remote patient monitoring (RPM) may enable safe early discharge for clinically stable patients awaiting surgery.

To evaluate the feasibility, safety and outcomes of a virtual ward pathway using RPM for patients awaiting urgent CABG surgery.

A prospective, multicentre, single-arm study was conducted across three UK cardiac centres (December 2022–May 2025). Eligible patients were discharged home with daily symptom reporting via a digital platform and structured clinician review. The primary outcome was preoperative major adverse cardiovascular events (MACE). Secondary outcomes included 30-day mortality, resternotomy, time to surgery, postoperative stay, readmissions and patient experience.

128 patients were enrolled (mean age 61 years; 87% male). No preoperative MACE occurred (0%; 95% CI 0.0% to 2.3%). 30-day mortality was 0% (95% CI 0.0% to 2.9%), and resternotomy occurred in 2.3%, comparable to national rates. Median time from discharge to surgery was 10 days, saving an estimated 1152 inpatient bed-days. Postoperative length of stay was 7.0 days compared with a national average of 8.0 (p=0.084). Patient experience was favourable: 95% felt safe at home, and 89% found the platform easy to use.

A virtual ward pathway with remote monitoring for selected patients awaiting urgent CABG was safe, feasible and associated with high patient acceptability and major reductions in inpatient utilisation. These findings support this model as a scalable approach to managing urgent surgical pathways while preserving safety and surgical timelines.