Qamil Pajaziti
Introduction
A Virtual Hospital (VH) model was introduced at an NHS trust performing approximately 250 major elective colorectal surgeries annually. It aimed to reduce inpatient length of stay (LOS) and bed usage. Early discharge was supported through remote monitoring and multidisciplinary input. This audit assessed the VH’s impact on LOS and surgical activity.
Methods
A retrospective audit was performed on patients undergoing ileostomy reversal at a single NHS trust. A pre-VH implementation (24/11/2021–23/11/2023) and a post-VH implementation (29/11/2023–25/01/2025) were compared. Patients in the VH group were discharged with a structured remote care package, including Masimo SafetyNet monitoring and twice-daily virtual reviews. The primary outcome was mean hospital LOS.
Results
A total of 95 patients were included (61 pre-VH, 22 VH). Mean LOS decreased from 4.82 days (95% CI: 3.59–6.05) to 1.18 days (95% CI: 1.01–1.36) following VH implementation, representing a statistically significant (p < 0.001) reduction of 76%. Eighteen patients in the VH group were discharged after just one day, compared to only one in the pre-VH group. Additionally, elective ileostomy reversals increased during the VH period, reflecting improved surgical throughput. There was no significant difference in complication or readmission rates.
Conclusions
The introduction of a Virtual Hospital care pathway significantly reduced hospital length of stay following ileostomy reversal, with a concurrent rise in operative throughput. These findings support the wider adoption of virtual care models to enhance perioperative recovery and optimise bed utilisation in colorectal surgery.
Authors
Qamil Pajaziti
West Hertfordshire Teaching Hospitals NHS Trust, Hertfordshire, United Kingdom
Lorna Boothroyd
West Hertfordshire Teaching Hospitals NHS Trust, Hertfordshire, United Kingdom
Bibechan Thapa
West Hertfordshire Teaching Hospitals NHS Trust, Hertfordshire, United Kingdom
Syed Mohsin
West Hertfordshire Teaching Hospitals NHS Trust, Hertfordshire, United Kingdom
Samuel Massias
West Hertfordshire Teaching Hospitals NHS Trust, Hertfordshire, United Kingdom
Najib Daulatzai
West Hertfordshire Teaching Hospitals NHS Trust, Hertfordshire, United Kingdom
Vanash Patel
West Hertfordshire Teaching Hospitals NHS Trust, Hertfordshire, United Kingdom