The COVID-19 pandemic has sparked a renewed focus on digital health and a flurry of investments. At the same time, we are in the midst of a caregiver crisis. The pandemic has contributed to nurses considering leaving their jobs1 and increased turnover rates that are accelerating the nursing shortage.2-6 High-cost agency nurses are filling the place of acute care nurses who have left. Turnover of nursing support staff has also hit record levels.7,8 The remaining healthcare workforce is strained, overwhelmed, and exhausted. Care delivery staffing has been disrupted, and may never return to prepandemic models.

When teams are stretched thin and care needs are unmet, nurses are often the "last line of defense" for ensuring safe patient care. For years, hospitals have defaulted to nursing when patient care activities fall through the cracks, whether they are core professional nursing responsibilities or not. Health systems can no longer afford to rely on highly skilled RNs to manage work more appropriately performed by clinical support staff, for at least 3 reasons. First, when nurses assume additional work, it compromises their ability to prioritize the most critical care needs and puts patient safety at risk. Second, it is frustrating. Nurses want to provide the best care for their patients and are not likely to remain in a job that consistently pulls them away from the care they are educated to provide. Third, it is inefficient and costly when highly skilled clinicians spend time on work that could be accomplished by unlicensed assistive personnel.

The Use of Technology

Now more than ever, health systems must protect nurses from spending time on work that falls outside of core nursing responsibilities.9 Technology can make life easier for medical professionals and patients alike. It can help relieve the burden on the clinical nurse by enabling some responsibilities to be automated and more expedient, freeing time for nurses to prioritize more critical patient needs. There are numerous innovative technologies leaders should consider integrating into nurse workflow so care teams can think and work in new ways. Examples include the following:

* Technology-driven pumps and monitors that automate the collection of information needed for care

* Smart devices, including automated beds and vital sign monitoring

* Wearables that provide clinical data to the provider

* Virtual rounding technology that prompts patients and family members with questions via text to scale rounding efforts and prioritize needs

* Electronic white boards integrated with the electronic health record to keep patients and families up to date

* Centralized data command centers that integrate multiple systems into a single monitoring center, including coordination of care, requests for services, and discharge tracking

* Robotics to save nursing and ancillary care time10

* Artificial intelligence to assist with wound assessment and sepsis capture for nurses that results in quality outcomes at lower cost11

* Tele-technology that enables virtual inpatient care models, including virtual sitter and virtual expert RN models12

* Mobile apps that enable bidirectional communication between patients and clinicians across all levels of care. These can improve nurses' access to patient information, streamline communication and patient education, and provide patients themselves more control over their health. When digital health apps have the look and feel of other mobile apps such as Doordash or Netflix, which are already familiar to consumers, they will require minimal or no instruction.

Conclusion

A consumer digital engagement strategy is important as patients increasingly expect better access to their health information and desire to be more in charge of their own care. Digital technology provides an opportunity to include family members as part of the care team and has potential to provide updates when they cannot be physically present. Other sectors have done this well. In fact, in almost every other industry, a consumer will likely have a better digital experience than in healthcare. To date, provider digital strategy has typically focused on telemedicine, virtual visits, and physician workflow but has largely ignored inpatient acute care nursing workflow. It is time for healthcare leaders to "step up their game" and provide digital engagement strategies that are convenient, accessible, and effective.

Automation can provide clinician relief while reducing overall labor costs by improving engagement and efficiency. One area of opportunity is to automate workflows for routine, administrative, and nonprofessional work. These responsibilities tend to be among the least engaging for nurses, so automation in this area could also elevate staff engagement. Chief nurse executives and chief nursing informatics officers should think strategically about how to obtain and implement technologies that provide relief to patient care teams by improving inpatient workflow, while creating a more patient-centered experience. Through partnerships with shared governance councils and nurses at the point of service, leaders are encouraged to partner with other internal stakeholders including the chief information officer and chief financial officer to pilot workflow redesign and test new ways of delivering care.

The effects of the pandemic are indescribable and still being felt. Now is the time for the nursing community to come together, strengthen our leadership voice and role, and expand our influence to transform healthcare delivery through effective use of technology. Healthcare leaders must be proactive in seeking innovative, digital solutions that support care teams and particularly our nurses in improving clinical outcomes and driving operational efficiencies throughout the pandemic and beyond.

References