Virtual Ward for Early Discharge in Patients Receiving Inpatient Care

Rationale: Patients undergo extensive diagnostics and treatment adjustments during the early days of their hospitalization, which may become less imperative as their admission progresses. If a patient's vital signs stabilize after the initial hospitalization, and they only necessitate "less urgent" hospital care, an option is to transfer them to the Virtual Ward and thereby creating hospital capacity. This telemedicine-driven model presents an alternative to the conventional in-patient care approach. In the Virtual Ward, patients continue to receive care under supervision of the hospital physician but from the comfort of their own homes. This means the hospital oversees the monitoring of vital signs, performing diagnostics and treatment in the patient's home environment. A growing body of evidence supports the safety of "Virtual Wards." However, although proven safe, its feasibility remains uncertain.

Objective: To assess the feasibility of the Virtual Ward in six pre-defined sub-cohorts of non elective hospitalized patients within the current Dutch healthcare system.

Study design: This is a single-center prospective cohort trial with 6 sub-cohorts.

Study population: Admitted patients (minimum age 18) receiving inpatient care that are eligible for discharge to the Virtual Ward.

Intervention (if applicable): Patients will be discharged to the Virtual Ward with monitoring, diagnostics, and treatment at home.

Main study parameters/endpoints: To assess the feasibility of the Virtual Ward across six pre-defined sub-cohorts of non-elective hospitalized patients by determining the percentage of patients who provide informed consent and are successfully transferred to the Virtual Ward, with a feasibility threshold set at 30% for this pilot phase (adherence). Feasibility is determined per sub-cohort.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness: Patients who are admitted to the virtual ward can benefit from recovering in a home environment. Potential risks are that they are not within reach of the treating physicians in case of an adverse event. Patients need to fill in questionnaires and measure their own vital signs. There are no additional invasive interventions patients would need to undergo by participating in this study.

• Number of Eligible Patients Invited for Participation [Срок оценки: From enrollment to invitation during hospitalization (up to 7 days)]
• Number of Invited Patients Providing Informed Consent [Срок оценки: From enrollment to signing informed consent during hospitalization (up to 7 days)]
• Time from Study Inclusion to Transfer to Virtual Ward [Срок оценки: From informed consent to Virtual Ward admission (up to 7 days)]
• Number of Notifications Generated During Virtual Ward Monitoring [Срок оценки: From Virtual Ward admission up to 30 days after discharge]
• Number of Contact Moments with Virtual Ward Staff [Срок оценки: From Virtual Ward admission up to 30 days after discharge]
• Length of Stay in Hospital Ward Prior to Virtual Ward Transfer [Срок оценки: From hospital admission to Virtual Ward admission]
• Length of Stay in the Virtual Ward [Срок оценки: During Virtual Ward stay]
• Hospital Readmission Rate During Virtual Ward Stay [Срок оценки: During Virtual Ward stay]
• Hospital Readmission Rate Within 30 Days After Virtual Ward Discharge [Срок оценки: From Virtual Ward discharge up to 30 days]
• Change in Quality of Life as Measured by EQ-5D-3L [Срок оценки: From baseline (hospital inclusion) to end of Virtual Ward treatment]