Author(s): Vanessa Martinez, DNP, MHA, RN, CPHQ
Director Virtual Nursing Care - Kaiser Permanente
Dr. Vanessa A. Martinez is an accomplished healthcare professional with over 29 years of nursing experience in critical care and leadership with a strong commitment to patient safety and quality. Currently serving as the Senior Director of Quality & Safety Improvement at Kaiser Permanente, she oversees Virtual Nursing Care programs, significantly advancing healthcare delivery and patient outcomes. Dr. Martinez has been instrumental in leading various virtual nursing programs, including the Advance Alert Monitor (AAM), Virtual and Quality Safety Oversight (VALUE/eHospital), and Perinatal Early Risk Alert (PERL). Under her leadership, the AAM program received prestigious awards, such as the Kaiser Permanente National Lawrence Patient Safety Award in 2020, the IHF Gold Winner of the Austco Excellence Award for Quality and Patient Safety in 2021, and the John Eisenberg Award for Local Innovation in Patient Safety and Quality from The Joint Commission (TJC) and National Quality Forum (NQF).Her educational background is impressive, with a Doctorate Degree in Nursing Practice from Loyola University New Orleans, dual master's degrees in nursing and health care administration from the University of Phoenix, and Strategic Leadership from Cornell University. Dr. Martinez is also recognized as a Certified Professional in Healthcare Quality, a Quality Professional Fellow, a Patient Care Improvement System Advisor, a Caritas and HeartMath Coach, a TeamStepps Master Trainer, and a faculty member for the Watson Caring Science Institute and Kaiser Permanente. Dr. Martinez's dedication to advancing nursing and healthcare quality is evident through her numerous accolades, including the Kaiser's Emerging Leader Award, recognition as a Culture of Health High-Performing Manager, and awards for Care Experience Leadership and a Kaiser Permanente Nurse Scholar. Actively contributing to the healthcare community, Dr. Martinez engages in podium and poster presentations, publishes research findings, and provides podcast commentaries. Her commitment to promoting leadership and diversity in healthcare is demonstrated by her service on the board of directors of Women Healthcare Executives of Northern California. Her enthusiasm for shaping the future of healthcare delivery and improving patient outcomes reflects her unwavering dedication to advancing quality, safety, and innovation in virtual nursing care.

Elizabeth Scruth, PhD, MPH, RN, CNS, CCRN, CCNS, FCCM, FCNS, CPHQ
Executive Director of Clinical Quality Programs, data Analti - Kaiser Permanente
Lizzie Scruth is the Executive Director of Clinical Quality Programs, Data Analytics and Tele Critical Care for NCAL Kaiser Permanente. Lizzie completed her undergraduate degree and graduate degrees in Australia and her post graduate studies as a Clinical Nurse Specialist at UCSF . Lizzie developed the first virtual nursing team for NCAL KP that operates 24 hours a day monitoring care gaps on all patients outside the ICU in 21 hospitals. The team is now fully staffed with Quality Nurses with critical care backgrounds.

Competency Domain: Patient Safety

Description: We will discuss how a virtual nursing team can support an organization's efforts to enhance patient safety and reduce risk in the face of patient surges, work stoppages, and staff turnover. Demonstrate how we used clinician engagement and measures of care efficiency to identify gaps in care and remediate them through an interactive and actionable data source. Discuss the importance of leadership engagement and clinician buy-in in collaborating across disciplines, identifying barriers, developing interventions, designing new processes, and adapting solutions over time. Embracing the five principles of High Reliability to help healthcare organizations adapt to an ever-changing care delivery environment. Problem: The ongoing patient surges together with staffing shortages, leadership, staff turnover, and work stoppages, have created significant gaps in care. These gaps can compromise patient safety and quality of care and increase the chances of regulatory findings during surveys. Measurement: The virtual nurse leverages EMR dashboards for real-time monitoring of care gaps. If any care gaps are identified, the virtual nurse promptly alerts designated hospital personnel for immediate remediation. The action is logged in MIDAS, which can be accessed via Tableau. Tableau-generates run charts and disseminated at each medical center. Analysis: We conducted a comprehensive analysis to identify the prevalence of care gaps within our healthcare system; sedation care gaps accounted for 77% of all care gaps. We compared the post-intervention data with the baseline data, which resulted in a significant 50% improvement in addressing sedation care gaps. Implementation: We observed some variation in how care gaps were being addressed and identified a need for follow-up. We developed a standardized communication process between the virtual nurse and the hospital to follow up with the clinicians in real time to modify the order. Leaders receive daily care gap summary reports. Results/Discussion The virtual team incorporated standardized communication tools and TeamStepps principles of situation monitoring, leadership, and mutual support. Ongoing efforts are being made to modify regional policies on sedation, vasopressors, pain, and delirium management. These changes have improved hospital throughput, compliance with regulations and standards, and certification surveys.

Evaluation: Complete Poster Evaluation