Abstract
Purpose: Efficient patient flow is critical for managing capacity and delivering timely, equitable care in emergency departments (EDs). As patient acuity and census increased at Stanford Health Care (SHC), traditional Fast Track spaces were reassigned to higher-acuity patients, leaving lower-acuity patients with prolonged lengths of stay (LOS). Prolonged LOS increases the risk of patients leaving without treatment, impacting care outcomes. To address this, SHC’s Digital Health team and Emergency Services leadership developed an innovative Virtual Fast Track care framework using telehealth technology and multidisciplinary workflows.
Methods: This novel approach applies an "inverted telemedicine" model in which care is provided within the hospital facility but supported by remote providers and telehealth-enabled tools. Telehealth carts equipped with diagnostic peripherals, combined with nursing-led workflows, ensure seamless access to laboratory services, imaging, specialty consultations, and nursing care. The care framework integrates telehealth software into the electronic medical record, allowing providers to manage patients across multiple ED locations in real time. Emergency nurses serve as the cornerstone of this initiative, leading critical assessments, coordinating diagnostic procedures, and facilitating patient-provider communication using advanced telehealth systems.
Implementation: The Virtual Fast Track framework was operationalized through multidisciplinary collaboration among emergency nurses, providers, IT professionals, and executive leaders. Nursing leadership and digital health experts co-designed workflows to meet patient care needs, with specialized training provided to adapt telehealth tools for the ED. This process emphasized nursing innovation in optimizing workflows and integrating digital technology.
Implications: This initiative represents a transformative innovation in patient flow management, with potential to reduce avoidable ED admissions, optimize care delivery for lower-acuity patients, and enhance ED efficiency. By demonstrating how digital health addresses capacity challenges and improves patient outcomes, this work underscores the pivotal role of nurses in advancing healthcare delivery and integrating telehealth into practice. Insights from the development and implementation of the Virtual Fast Track care framework can inform future telehealth applications across diverse healthcare settings.
Notes
References:
Alshurtan, K., Almomtin, H., Alqhtani, K. F., Alqahtani, A., Aledaili, A., Alharbi, A., Alhejaili, M., Alreheili, S. H., & Aljassar, S. (2024). Breaking the Emergency Room Cycle: The Impact of Telemedicine on Emergency Department Utilization. Cureus, 16(3), e55457.https://doi.org/10.7759/cureus.55457
Castner, J., Bell, S. A., Hetland, B., Der-Martirosian, C., Castner, M., & Joshi, A. U. (2022). National Estimates of Workplace Telehealth Use Among Emergency Nurses and All Registered Nurses in the United States. Journal of Emergency Nursing, 48(1), 45-56. https://doi.org/10.1016/j.jen.2021.07.001
McHugh, C., Krinsky, R., & Sharma, R. (2018). Innovations in Emergency Nursing: Transforming Emergency Care Through a Novel Nurse-Driven ED Telehealth Express Care Service. Journal of Emergency Nursing, 44(5), 472-477. https://doi.org/10.1016/j.jen.2018.03.001
Scott, A. M., Sanders, S., Atkins, T., van der Merwe, M., Sunner, C., Clark, J., & Glasziou, P. (2024). The impact of telehealth care on escalation to emergency care: A systematic review and meta-analysis. Journal of Telemedicine and Telecare, 1357633X241259525. https://doi.org/10.1177/1357633X241259525
Sher, L., Semciw, A., Jessup, R. L., Carrodus, A., & Boyd, J. (2022). Structured evaluation of a virtual emergency department triage model of care: A study protocol. Emergency Medicine Australasia, 34(6), 907-912. https://doi.org/10.1111/1742-6723.14010
Sigma Membership
Alpha Alpha Lambda at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Interprofessional Initiatives, Public and Community Health, Interprofessional, Interdisciplinary, Clinical Practice, Technology in Practice, Telehealth, Telemedicine, Emergency Departments
Recommended Citation
Callagy, Patrice and Cheung, Maria, "Integrating Telehealth Innovation to Advance Emergency Department Flow and Nursing-Led Care" (2025). Biennial Convention (CONV). 140.
https://www.sigmarepository.org/convention/2025/presentations_2025/140
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-12-01
Integrating Telehealth Innovation to Advance Emergency Department Flow and Nursing-Led Care
Indianapolis, Indiana, USA
Purpose: Efficient patient flow is critical for managing capacity and delivering timely, equitable care in emergency departments (EDs). As patient acuity and census increased at Stanford Health Care (SHC), traditional Fast Track spaces were reassigned to higher-acuity patients, leaving lower-acuity patients with prolonged lengths of stay (LOS). Prolonged LOS increases the risk of patients leaving without treatment, impacting care outcomes. To address this, SHC’s Digital Health team and Emergency Services leadership developed an innovative Virtual Fast Track care framework using telehealth technology and multidisciplinary workflows.
Methods: This novel approach applies an "inverted telemedicine" model in which care is provided within the hospital facility but supported by remote providers and telehealth-enabled tools. Telehealth carts equipped with diagnostic peripherals, combined with nursing-led workflows, ensure seamless access to laboratory services, imaging, specialty consultations, and nursing care. The care framework integrates telehealth software into the electronic medical record, allowing providers to manage patients across multiple ED locations in real time. Emergency nurses serve as the cornerstone of this initiative, leading critical assessments, coordinating diagnostic procedures, and facilitating patient-provider communication using advanced telehealth systems.
Implementation: The Virtual Fast Track framework was operationalized through multidisciplinary collaboration among emergency nurses, providers, IT professionals, and executive leaders. Nursing leadership and digital health experts co-designed workflows to meet patient care needs, with specialized training provided to adapt telehealth tools for the ED. This process emphasized nursing innovation in optimizing workflows and integrating digital technology.
Implications: This initiative represents a transformative innovation in patient flow management, with potential to reduce avoidable ED admissions, optimize care delivery for lower-acuity patients, and enhance ED efficiency. By demonstrating how digital health addresses capacity challenges and improves patient outcomes, this work underscores the pivotal role of nurses in advancing healthcare delivery and integrating telehealth into practice. Insights from the development and implementation of the Virtual Fast Track care framework can inform future telehealth applications across diverse healthcare settings.
Description
The Virtual Fast Track framework leverages telehealth technology and nursing-led workflows to optimize patient flow in the ED. This innovative care model integrates advanced digital tools, enabling remote providers and on-site nurses to deliver timely care for lower-acuity patients. Multidisciplinary collaboration and nursing leadership were critical to its implementation, demonstrating the potential to improve ED efficiency, reduce avoidable admissions, and enhance patient outcomes.