The highly transmissible nature of COVID-19 resulted in a hospital-wide ban on in-house meetings. Many departmental meetings had to be restructured as secure remote meetings.

Following the approval from the hospital leadership and the legal department, a 280-bed academic hospital made several adaptations to the nurse peer case review (NPCR) council structure in June 2020. The confidentiality agreement was reviewed at the commencement of each virtual meeting, reminding the members of the Health Insurance Portability and Accountability Act compliance when discussing and reviewing patient electronic health records (EHRs). The meeting attendance was recorded through a QR code, and minutes were documented on the hospital-provided encrypted online folder.

There were several advantages of holding virtual meetings. Participants no longer had to commute for a 2-hour meeting, increasing staff participation. Attending the meeting virtually from the comfort of their home allowed staff more time for self-care and to enjoy their days off.

The challenges encountered during the NPCR process adaptation included accessing EHR at home, which was dependent on reliable internet access, access to computer devices, video access, Virtual Private Network (VPN) access, available space, and privacy. The hurdles to the new process included council members not actively interacting due to the ease of multitasking and communication challenges. As the COVID-19 pandemic persists, there have been ongoing challenges over the past 2 years, including persistent changes in guidelines and restrictions as well as staffing and resources concerns, requiring continuous flexibility with the new NPCR process.