Fraser Health Virtual Care is a health service available to Fraser Health residents that connects them via telephone, video or webchat with a registered nurse for care consults and virtual assessments, clinical information and advice, and referrals to Fraser Health services.
In Summer 2021, Virtual Care expanded its services to begin conducting post-discharge follow-up calls for patients discharged from the Emergency Department or inpatient care. The service targets patients at moderate to high risk of revisit or unplanned readmission to the hospital within 30 days after discharge.
Evaluating the program has been a priority for the Virtual Care leadership team since the beginning. The team decided to take a phased approach to the evaluation, a decision that was made after considering the resources available and evaluation readiness of the program.
In early 2021, the team conducted a health economic appraisal focused solely on the inbound calls service (where patients call Virtual Care and Virtual Care nurses advise the patients). This analysis determined that patients were satisfied with the care they received, and that they self-reported clinical and economic benefits from using Virtual Care. This evaluation helped the team develop an action plan to improve impact measurement of this service.
After the team rolled out the post-discharge calls service (where Virtual Care nurses call discharged patients), there was a need to identify areas of improvement to ensure patients received the highest quality service possible. The team conducted a telephone survey to capture the experience of patients and Virtual Care nurses in Summer 2021. Although based on a small sample, the patients surveyed reported being better able to manage their plan of care after receiving a post-discharge follow up call. Feedback from both patients and Virtual Care nurses also informed rapid quality improvement cycles.
While experience surveys are key to ensure the delivery of high quality services, additional analysis is required to assess the impact of programs. The team is currently developing a more robust evaluation to assess the impact of follow-up discharge calls by comparing outcomes of patients receiving post-discharge phone calls from a Virtual Care nurse relative to those of a control group.
Using a phased approach to evaluate the initiative allowed the team to answer priority questions while preparing their data infrastructure and securing resources for an impact evaluation. It also provided flexibility to conduct smaller evaluations that facilitated rapid cycle improvements to increase the quality of services provided to patients.