Covid-19 has seen an acceleration in assistive technology in the clinical space (Virtual wards) to mitigate risk and care for patients safely and effectively.
The Norfolk and Norwich University Hospital (NNUH) serving a population of approximately one million, is the first UK hospital to set up a 24 hour acute VW for the management of medical and surgical patients during the Covid-19 pandemic.
Patients admitted to the VW are considered in-patients. Patients have 24/7 monitoring using the "Current Health monitoring system" by a nursing team with daily consultant review. The VW has 40 monitored beds.
Since 2021, 1,988 medical and surgical patients have been through the service with 15,604 bed days saved and an average LOS of 7.8 days.
This was a retrospective review of prospectively collected data on all respiratory patients admitted to the VW at NNUH between 09/2/21-19/2/23
Table 1 - Inclusion criteria for respiratory patients to the VW
| Copd | Bronchiectasis | Pneumonia | Empyema | Covid-19 |
|
Afebrile, no or low flow oxygen requirement, normal CXR or single lobar consolidation, single organ involvement Requiring nebuliser wean |
Need for 10-14 day of iv antibiotics |
Clinically improved, afebrile for >24 hours, improvement in inflammatory markers but requiring wean from oxygen | Clinically improving (afebrile, improving inflammatory markers) - needing prolonged iv antibiotics |
Stable patients with an oxygen requirement |
Table 2 - 2 year experience of respiratory patients
| Respiratory In-patients through the VW | Bed days saved | Average VW LOS | Ward attenders (not needing continuous monitoring) | Patient satisfaction |
| 484 | 3282 | 6.8 | 202 | 98.6% |
VW in respiratory medicine has saved bed days with a positive patient experience.