Remotely Possible: Telecritical Care Transition to Remote Work Improves Satisfaction and Saves Cost

Introduction: Telecritical Care (TCC) services continue to evolve in structure, applications, and technology. The hub and spoke system is a prevalent structure, with a single remote center with dedicated staff that provides services to multiple sites. This project aimed to move the primary mode of care delivery from a geographically Centralized Operations Room (COR) to a remote model with adequate technology, communication, and support, while maintaining the high standards of care associated with this TCC.


Methods: This process began in 2020 during the COVID-19 pandemic as a phased approach to reduce in-person exposure with ~10 teammates. This early successful proof of concept (connectivity, Internet providers, technology, team communication and collaboration) allowed leadership to work through potential complications and barriers to effective remote work and assess needs of the TCC nurse working remotely. Over the next several years, the percentage of RN shifts worked remotely increased incrementally. Finally, in early 2024 a telecommunications solution allowed the unit coordinators and virtual Respiratory Therapists to move to remote work, allowing the COR space to be downsized.


Results: TCC now supports ~125 remote users. TCC reduced sq. footage in the COR by more than 50%, resulting in nearly a 54% cost reduction. Absenteeism decreased sharply from an average of ~180 per year in 2018-2019 to 89 in 2020 with continued downward trends to 41 in 2024 (full expanded remote work), and 25 in the first 6 months of 2025. Work-life balance is improved as teammates now work only 2 shifts in the COR in a 6-week schedule. On average, annual savings for a full-time employee is 148 hours, 5,421 miles driving, and over $600 in gas. Each week of remote work saves the VCC team ~3,080 miles. Across the whole team, over 160,000 miles are saved each year with greater than 5,000 hours of driving and $480,500 savings experienced by the team. There were no delays or adverse outcomes to patient care due to the expanded remote model.


Conclusions: Remote work is a cost-effective option for telecritical care teams, with savings in physical space offsetting initial hardware costs for remote users. It can improve team satisfaction and work life balance while reducing costs with no negative impact on the quality of care provided.