Implementing a COVID-19 Virtual Observation Unit in Emergency Medicine: Frontline Clinician and Staff Experiences

• Published in: Medical care research and review Vol. 80; no. 1; pp. 79 - 91
• Main Authors: Jung, Olivia S., Graetz, Ilana, Dorner, Stephen C., Hayden, Emily M.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-02-2023; SAGE PUBLICATIONS, INC
• Subjects: Clinical Observation Units; Coordinators; Coronaviruses; COVID-19; Emergency medical care; Emergency medical services; Emergency Medicine; Emergency Service, Hospital; Emergency services; Empirical Research; Health care; Hospitals; Humans; Integrated care; Pandemics; Paramedics; Patient participation; Patients; Professional attitudes; Reconfiguration; Remote monitoring; Staff participation; Telemedicine; Virtual reality; remote patient monitoring; COVID-19; digital health; telehealth; implementation; emergency department; mobile integrated health care; virtual health; community paramedicine
• ISSN: 1077-5587; 1552-6801
• DOI: 10.1177/10775587221108750

The COVID-19 pandemic pushed hospitals to deliver care outside of their four walls. To successfully scale virtual care delivery, it is important to understand how its implementation affects frontline workers, including their teamwork and patient-provider interactions. We conducted in-depth interviews of 17 clinicians and staff involved with the COVID-19 Virtual Observation Unit (CVOU) in the emergency department (ED) of an academic hospital. The program leveraged remote patient monitoring and mobile integrated health care. In the CVOU (vs. the ED), participants observed increases in interactions among clinicians and staff, patient participation in care delivery, attention to nonmedical factors, and involvement of coordinators and paramedics in patient care. These changes were associated with unintended, positive consequences for staff, namely, feeling heard, experience of meaningfulness, and positive attitudes toward virtual care. This study advances research on reconfiguration of roles following implementation of new practices using digital tools, virtual work interactions, and at-home care delivery.