6358 Paediatric virtual wards: re-designing family centred care

Objectives Virtual wards (VWs) have the potential to transform care by relieving bed pressures and improving patient experience.1 More established within adult settings, paediatric VWs remain uncommon. Following a successful pilot, the objective was to implement an established paediatric VW at a tertiary paediatric centre within six months. The VW aimed to promote recovery at home, support discharges and avoid admissions. A framework was developed to measure impact. Methods The pilot enabled scope to develop a business case. A road map was designed with stakeholders to outline recruitment, pathways, and performance indicators. The Healthier at Home VW was established and within a month expanded to operate weekdays 9am-8pm. A standard operating procedure provided a clear vision to ensure safety. A patient was eligible for admission with one of six diagnoses (figure 1). A prospective study was conducted to capture impact, utilising a mixed method approach of quantitative and qualitative data. Results In the first month the VW admitted a mean of 2.8 patients/day from acute attendances to the assessment unit, with a diagnosis as per figure 1. A reduction in length of stay on the unit was seen for all patients admitted to VW (516 minutes), compared to the pilot control group (695 minutes). For patients attending in hours, when the service was available, length of stay on the unit was significantly shorter (205 minutes). Length of VW stay ranged from 78–225 minutes. 8 patients reattended, only 3 because of worsening symptoms. No reattenders required inpatient admission. All families reported they found the service useful and would recommend it to family and friends. Common themes reported were quicker discharges, cost and logistical benefits including work and childcare (figure 2). 100% of staff felt it would benefit patients and families, with all clinical staff happy to promote the service. Unexpected benefits were identified, further promoting the health and wellbeing of children. In one case, the assessing clinician identified poor housing during virtual consultations, and was able to escalate with local services. Conclusion This study demonstrates rapid successful establishment of a paediatric VW. We have shown the feasibility of VWs within paediatric acute care, alongside areas of measurable benefit. The VW promotes health education and ensures safe timely discharges. It is valued highly by families and staff, improving the overall patient care experience. The VW puts the child at the centre, allowing families easier access to services. Reference NHS England, NHS England, 2023.