Launching a Virtual Nursing Program: Crawl, Walk, Run

Virtual nursing is quickly moving from an experimental idea to a practical solution for hospitals under pressure from staffing shortages, rising patient volumes, and cost concerns. But success doesn’t come from rushing into a large rollout. Instead, hospitals can approach the process in phases—Crawl, Walk, and Run—to build stability and long-term sustainability. Read more

The Crawl Stage: Defining the “Why”

Every program begins with purpose. At this stage, leadership should clearly define why virtual nursing is being considered. Is it to relieve overworked staff? Improve admission and discharge times? Enhance patient satisfaction?

A thorough needs assessment sets the foundation. Leaders evaluate patient volumes, staffing constraints, and existing workflows. Equally important is assessing the organization’s technology readiness—whether the infrastructure can support remote workflows and whether bedside teams are prepared for the change.

Staffing models are also a key decision here. Hospitals can rely on in-house nurses, contract with external virtual staff, or use a hybrid model. Many choose hybrid to gain outside expertise while building internal capacity over time.

The Crawl stage ends when the hospital has defined goals, selected a staffing strategy, and outlined clear parameters for moving forward.

The Walk Stage: Testing and Refining

In the Walk stage, the program begins to operate. Technology platforms are deployed, nurses are trained, and workflows are tested in real conditions. Bedside staff and virtual nurses learn how to collaborate, and roles are refined to avoid overlap or confusion.

This is also the point where metrics become essential. Hospitals should track indicators such as:

• Patient satisfaction scores
  
• Staff retention and morale
  
• Admission and discharge efficiency
  
• Cost per interaction or time saved per shift
  

Collecting and reviewing data helps leaders identify what is working, where adjustments are needed, and whether the program is meeting its original goals.

A common challenge at this stage is “role slippage”—when virtual nurses get pulled back into bedside duties. Preventing this requires clear boundaries and ongoing support from leadership.

The Run Stage: Scaling for Impact

Once processes are stable and outcomes are positive, hospitals can move to the Run stage. Here, the program expands across more units or even the entire health system. Virtual nurses become a standard part of care delivery rather than a pilot initiative.

Scaling brings new complexities—more staff, more patients, and more data—but also bigger rewards. Hospitals often see significant improvements in nurse retention, reduced burnout, faster throughput, and higher patient satisfaction.

Organizations may revisit earlier stages as they expand to ensure consistency and quality. The key is to maintain the program’s structure and purpose while adapting to larger scope.

Real-World Outcomes

Hospitals that have followed this phased approach report measurable results. Some saved nearly two hours per shift in documentation, saw smoother discharge processes, and experienced meaningful drops in staff burnout. Others achieved double-digit improvements in nurse retention, underscoring the value of integrating virtual nursing into long-term workforce strategies.

Moving Forward

Launching a virtual nursing program is less about speed and more about strategy. Hospitals that pause to clarify their “why,” pilot carefully, and scale thoughtfully are better positioned to deliver sustainable improvements in care quality, staff satisfaction, and financial performance.

By following the Crawl-Walk-Run model, hospitals can transform virtual nursing from a short-term experiment into a lasting advantage.