Abstract
Introduction Surgical interventions for older adults are increasing as the population ages. This demographic has a higher perioperative risk. Perioperative care through virtual wards (VWs) is a new service, allowing patients to remain at home. We compared operational and clinical metrics between two age groups (65+ and <65 years) receiving surgical inpatient care through a VW service to evaluate safety and efficacy.
Methods The VW service at Wrightington Wigan and Leigh (WWL) NHS Foundation Trust cared for patients at home using the Current Health (CH) platform for medical and surgical inpatients. Patients wore a device that transmitted vital signs, allowing VW staff to monitor real-time data. Patients in this service would have otherwise been hospitalized; bed days saved were estimated based on clinical judgment. De-identified and aggregated data from January 14, 2022, to January 31, 2024, were analysed to evaluate differences between older (65+ years) and younger (<65 years) patients. Fisher’s exact, t-tests and Mann-Whitney tests compared outcomes.
Results There were 75 younger patient admissions (mean age 47.5 ± 11.1 years, 57% female) and 30 older patient admissions (mean age 72.7 ± 6.0, 53% female). Both groups had a similar VW length of stay (mean 9.3, SD 5.4 days), bed days saved (median 7, IQR 5-7 days), and adherence (median 92%, IQR 87-96%). Median alarms per patient-day were 2.9 (IQR 1.4-5.4). In total, seven patients (6.7% of admissions) returned to the hospital. Of those, four patients presented to A&E out of hours from the VW (2 per group). There were no escalations to community services or adverse events.
Conclusion The VW service has successfully managed surgical inpatients from their homes, demonstrating good adherence, bed days saved, minimal hospital returns, and no adverse outcomes in both older and younger patients. There were no statistical differences in operational or clinical outcomes between groups.