Early ROI indicators for virtual nursing success | Viewpoint

Virtual nursing stands as a defining innovation of our era, one whose impact will only deepen as we perfect our approaches and unlock new possibilities.

Dr. Christine Gall

This progressive care delivery model represents a bold path forward in addressing our nursing workforce crisis—a profession that has endured not just chronic shortages and burnout, but an escalating burden of challenges from multiple directions.

Against this backdrop, virtual nursing offers genuine promise to mitigate the competing challenges that create barriers to the provision of streamlined, top-quality care.

Demonstrating the value of virtual nursing

Supporting our nurses is the right thing to do, but any major initiative must demonstrate clear return on investment to secure sustainable funding and organizational commitment. The encouraging news is that even though adoption of virtual nursing is still in its early days, we're already seeing promising indicators that suggest these programs can deliver measurable value across multiple dimensions of hospital performance.

As healthcare leaders, we must resist the temptation to wait for perfect data before acting. Instead, we should focus on tracking the indicators that can guide our decisions and demonstrate progress.

While virtual nursing's financial impact may not always be immediately obvious in direct cost savings, the value becomes clear when you look at the right performance indicators. Based on emerging evidence from health systems nationwide, four key metrics are proving most valuable for assessing virtual nursing ROI.

Nurse retention and engagement

Perhaps the most compelling indicator is improved nurse retention and job satisfaction.

Recent data shows the average cost of replacing a bedside RN has climbed to $61,110, with hospitals losing between $3.9 million and $5.7 million annually to turnover—making even small improvements in retention financially transformative.

Virtual nursing programs consistently report enhanced nurse engagement through reduced administrative burden and better work-life balance. According to Press Ganey data, hospitals with the highest nurse engagement scores have turnover rates 5.6 percentage points lower than those with the lowest scores. With reduced turnover translating to $313,000 in cost savings for every 100 RNs, the financial impact of improved engagement is substantial.

Patient experience scores

Virtual nursing shows particular promise in improving three critical HCAHPS domains that directly impact Medicare reimbursements: communication with nurses, communication about medications, and discharge information.

Research demonstrates that virtual nursing programs can enhance performance across all three categories—patients report better access to nursing support and more timely responses to their questions, more comprehensive medication education and reconciliation processes, and clearer, more thorough discharge instructions delivered without the interruptions that often plague busy floor nurses.

Since HCAHPS scores directly impact both reimbursement rates and public quality ratings, improvements in these nursing-sensitive domains represent both immediate financial benefits and long-term competitive advantages.

Falls with injury prevention

Patient falls represent both a significant safety concern and a substantial financial burden, with the average total cost of a fall reaching $62,521 when accounting for extended length of stay, additional treatment, and liability exposure. Virtual nursing programs incorporating continuous patient observation have demonstrated remarkable effectiveness in fall prevention, with some organizations reporting reductions of up to 100% in preventable patient falls.

Virtual observation allows for real-time monitoring of high-risk patients, immediate response and redirection when unsafe behaviors are detected, and consistent application of fall prevention protocols without the staffing constraints that often limit traditional one-on-one sitters.

Beyond the obvious patient safety benefits, the financial impact is substantial—preventing even a small number of falls can generate significant cost savings while improving quality metrics. Further, the impact of fall avoidance to the healing process and quality of life for patients cannot be underestimated.

Reduce readmissions

Preventing avoidable readmissions represents one of virtual nursing's most significant financial opportunities, given that 30-day readmissions cost hospitals an average of $16,000 per episode and can trigger Medicare penalties.

Virtual nurses excel at mitigating the root causes of readmissions through uninterrupted discharge education, accurate medication reconciliation, post-discharge follow-up calls, and seamless communication with outpatient providers. Additionally, virtual nursing platforms enable remote family participation in discharge education, ensuring that key caregivers receive critical information regardless of physical presence.

The uninterrupted time virtual nurses can dedicate to each patient—compared to floor nurses managing multiple competing priorities—allows for more thorough education and care transition planning.

Successful virtual nursing programs report improved readmission rates and high patient and nurse satisfaction, suggesting that virtual nursing can simultaneously enhance quality outcomes while reducing costly penalties and improving hospital margins.

Potential clinical benefits

While these four indicators provide the strongest early evidence for ROI, virtual nursing's potential extends to other critical clinical measures.

Depending on the specific model implemented, we may see improvements in medication errors and adverse drug events through real-time medication reconciliation support and timely double-checks for high-risk medications; reductions in hospital-acquired infections via enhanced surveillance protocols; better pressure ulcer prevention through continuous monitoring and positioning reminders; and fewer code blue events through proactive virtual rounds for signs of clinical deterioration and timely activation of rapid response resources.

However, the impact on these outcomes will largely depend on the scope and sophistication of the virtual nursing program—a basic virtual observation model will deliver different results than a comprehensive virtual care team with advanced monitoring capabilities and clinical decision support tools. As clinical teams develop the competencies to effectively leverage virtual team members for care delivery

The bottom line

Whether focusing on these four proven indicators or monitoring targeted clinical outcomes, the advantage of virtual nursing lies in its ability to generate measurable improvements that connect upstream workforce investments to downstream patient and financial outcomes.

While the comprehensive evidence base for virtual nursing ROI is still evolving, these early indicators provide compelling reasons for optimism.

The key is choosing metrics that matter most to your organization and tracking progress consistently. As we continue to navigate workforce challenges and financial pressures, virtual nursing represents not just a technological advancement but a strategic investment in the sustainability of excellent patient care.

Dr. Christine Gall is the chief nursing officer of Collette Health.