Advancing Pediatric Care: The virtualKIDS Experience in Nursing-Led Audio-Visual Clinical Services

BY Eunice Toriola

The Sydney Children’s Hospital Network is located in New South Wales, the most populous state in Australia. It is comprised of two children’s hospitals that forms one of the largest children’s hospital networks in the country. Our network recognised the need to develop virtual care as an integral part of providing specialist paediatric care to the children and adolescents within our state. As a result, the virtualKIDS service was proposed in 2020 and launched in June 2021. COVID-19 further accelerated the establishment of this service.

The target was to transform the delivery of healthcare that is being provided to the pediatric and adolescent population that was seen by the Sydney Children’s Hospital Network by adopting technology. The service was designed with 3 objectives in mind: The first, reducing hospital admissions or emergency presentations, length of stay and the associated resource allocations. The second, support and collaborate with local clinicians in delivering pediatric care closer to home, especially evident in a geographically spread region. Thirdly, enabling children to spend more time at school and within their local communities while minimizing parental and family unit disruptions.

There are several pathways for children and adolescents to be reviewed by the virtualKIDS service, which is all explained within our recent publication. The two main pathways with the largest number of children being seen include:

Acute Review (post-hospitalization care)- supporting patients who have been discharged from the emergency departments or the wards requiring post-hospitalisation support or monitoring for their respiratory, hydration or overall general condition. A consult is conducted through audiovisual consultation and the families can contact virtualKIDS for up to 72 hours.

Virtual Urgent Care (ED avoidance) – providing a specialised pediatric assessment for a select group of children who have accessed a national clinical help line (known as HealthDirect). The virtualKIDS will re-assess the child referred onto our service with a clinical software tool that populates questions in addition to the audiovisual clinical assessment that will enable the clinician to recommend urgency or even the necessity of a presentation to an emergency department.

The service is run by a team of specialist pediatric nurses with support of paediatricians. The virtualKIDS service operates round the clock, even on public holidays. The service is designed to provide clinical care using audio-visual assessments. By exclusively using an audio-visual platform, valuable information is obtained that helps the clinicians to provide safe and effective clinical care or recommendations. The platform we use is accessible on any camera enabled device irrespective of the make or model.

Additionally, we provide families the ability to access the virtualKIDS service via a designated number enabling families the ability to seek information and advice for their child should there be any concerns or deterioration, an assessment can easily be performed by the specialist nurse by swiftly converting the call into an audiovisual assessment. If the nurse identifies the child needs a face-to-face assessment or medical attention, the family and patient are guided to an in-person consultation with their local general practitioner, emergency department, or specialized outpatient clinic. Often, these families are given a recommendation, simple treatment though telehealth that may avoid a visit to a healthcare facility altogether.

The virtualKIDS service is constantly developing and expanding, focusing on how to benefit the paediatric and adolescent population within the state of New South Wales, whilst working together with more health services within The Sydney Children’s Hospital Network and relevant stakeholders state-wide. Our future projects for virtualKIDS includes expansion into utilising other technological devices for examples remote patient monitoring, and additionally expansion into coordinating non-urgent hospital transfers that require paediatric specialist nursing and medical support.

Article details

Advancing Pediatric Care: The virtualKIDS Experience in Nursing-Led Audio-Visual Clinical Services
Eunice Toriola, Lyn Biviano, Christine Lau, Natalie Hooke, Amie Donnelly, Emma Dickins, Sandra Pengilly, Joanne Ging, Nadine Shaw, Jagdev Singh
First Published: 11th April 2024
DOI: 10.1177/10784535241245667
Creative Nursing

About the Author

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Eunice is an enthusiastic Clinical Nurse Consultant who has worked in multiple senior positions within the public health sector. Eunice has over 14 years’ experience in paediatric nursing and over 9 years within the organ transplantation sub-specialty. Currently working with virtualKIDS since conception of the service in June 2021. She is passionate about providing care to her patients and their families in a time of acute and chronic care. Eunice has presented at numerous conferences over the years both internationally and domestically showcasing strategic change and workflows that were developed and implemented.

Eunice has completed a Master of Nursing, majoring in Advanced Clinical Practice, and sub-majoring in Pediatrics from University of Technology, Sydney, and a Graduate Certificate in Renal Nursing from University of Tasmania. Eunice is currently studying a Graduate Certificate in Child and Family Health from University of Technology, Sydney.