Julie Tuel, RN, system vice president, virtual care nursing practice transformation, at CommonSpirit Health
Photo: CommonSpirit Health
Hospitals and health systems across the country are facing significant hurdles as experienced nurses step away from the bedside – leaving critical mentorship gaps and making it increasingly difficult to support newer clinicians in high-pressure environments.
THE CHALLENGE
CommonSpirit Health, which delivers care across 2,300 care sites including 158 hospitals in 24 states, knows this challenge.
Nursing teams among most health systems are feeling overwhelmed with an increasing load of administrative tasks.
CommonSpirit is actively navigating these challenges in nursing staffing and experience. The geographical breadth of its locations across two-dozen states presents an opportunity to make use of valuable nursing experience across a variety of rural and urban settings to scale best practices and deliver consistent quality and care standards, said Julie Tuel, RN.
PROPOSAL
The health system's virtually integrated care model aims to integrate a virtual nurse into the local care team, alleviating the workload of bedside staff.
"The primary focus of this proposal was to transfer tasks that do not necessitate physical presence or hands-on care to the Virtually Integrated Care RN," said Tuel, who serves as system vice president for virtual care nursing practice transformation at the Chicago-based health system.
Beyond her RN degree, Tuel has earned certifications including CCRN, for high-acuity critical care; SCRN for stroke management, and CAVRN, or Certified Acute-Care Virtual Registered Nurse, which focuses on remote monitoring and tele-ICU.
She used that expertise to help develop the virtual nursing model.
"We wanted to empower our nurses to focus on what they love to do – provide compassionate, hands-on patient care – by offloading duties that didn't require their immediate bedside presence. It was a chance to redesign how care is delivered altogether while protecting their well-being and job satisfaction.
"Additionally, by using an expert clinician behind the camera, the model is designed to offer valuable mentorship and real-time assistance to novice nurses," she continued. "This strategic addition of expertise is intended to enhance job satisfaction throughout the unit and ultimately reduce nursing turnover."
MEETING THE CHALLENGE
CommonSpirit Health developed proprietary software for its telehealth and virtual nursing programs. This internal ownership has enabled swift development driven by direct feedback from patients and staff, ensuring the technology integrates smoothly with bedside workflows.
"The VIC model now has been successfully implemented across 1,075 beds," Tuel reported. "Thanks to the program's effectiveness and high levels of engagement from both staff and patients, we have broadened our reach from initial acute care settings to include emergency departments and critical care units.
"We are on track to expand to 3,000 beds by July 1 and currently are in the discovery phase to further extend these services across the care continuum, including ambulatory, ancillary and senior living support," she added.
RESULTS
Prior to the introduction of the VIC program in any hospital, staff gather baseline data in collaboration with local, regional and national leadership. These data points are reviewed monthly, and action plans are developed as necessary to ensure ongoing improvement.
From February to December 2025, the VIC team facilitated 808,200 virtual visits for patients, families and bedside care team members.
Across the CommonSpirit Health enterprise, she reported the program has achieved:
- A 43% reduction in first-year RN voluntary turnover.
- A 37% reduction in both central line-associated bloodstream infections and catheter-associated urinary tract infections.
- A 20% increase in "communication with nurses" scores on HCAHPS.
- A 21% decrease in emergency department hold hours with the newly implemented model.
Further, CommonSpirit Health received the American Telemedicine Association 2025 Nexus Transformational Leadership Award. The health system is a member of the ATA Center of Digital Excellence.
"The success of our model hinges on the integration of the VIC nurse with the care team and embedding virtual workflows into both organizational and unit processes, supported by mentorship from expert nurses behind the scenes," Tuel explained.
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