Virtual Wards - Key Aims of Virtual Wards

Key Aims of Virtual Wards

The key aims of virtual wards are to:

• Act on evidence-based forecasts from predictive risk modeling in order to reduce non-elective secondary care (acute hospital) usage;

• Provide multidisciplinary case management;

• Serve as a communications hub for all those involved in the care for these complex patients;

• Offer intuitive working systems that appeal to patients and clinicians alike.

Using risk stratification, patients can be identified by their likelihood to require admission into hospital within the next year. The group of patients examined in this way can be based on a practice, a group of practices, or by a number of long term conditions. The most commonly used risk stratification tool is the PARR++ Algorithm, which is available to NHS institutions free of charge - the tool takes data available from hospital admissions for the last four years and generates a percentage risk score. A more thorough tool is in development called the BUPA Health Dialogue risk stratification tool, which also accesses hospital data, but adds in data from the patients' practice to generate a risk score - the higher the score, the greater the risk of admission. This tool is available to NHS organisations for a moderate annual subscription. Other Tools include the Milliman Advanced Risk Adjuster Tool provided by GPC Solutions Ltd in the UK that also indicates risk drivers and likely impact on areas of service.

Like a hospital ward, the capacity of the ward is set - usually between 0.5% and 1% of the number of patients grouped together. Also, like a hospital ward, patients are admitted and discharged from those beds. The ward is termed "Virtual" as these beds are not 'real', and care takes place in the most appropriate setting for the patient, usually at home. Initially, the patients at highest risk of admission to hospital are considered for admission to the ward and for intensive case management. When one of these "beds" becomes vacant as the patient stabilises then the predictive algorithm is looked to for a replacement.

The Virtual Ward team use enhanced tracking to ensure that they can reduce the likelihood of admission, and should the patient be admitted into secondary care follow their process through hospital and attempt to facilitate an earlier discharge back into the community.