Considerations for establishment of a private virtual hospital identified using an implementation science approach

Abstract

Abstract Virtual hospitals are rapidly being implemented internationally. Research has predominantly focused on clinical outcomes not implementation. We aimed to identify pre-implementation determinants to enable health services to tailor virtual hospital models, increasing likelihood of suitability, acceptability, uptake, clinical effectiveness, and sustainability. We aimed to inform the design and implementation of a private Australian virtual hospital by identifying contextual barriers, enablers, and considerations. We conducted a qualitative pre-implementation determinant study using snowball sampling and semi-structured interviews ( n  = 37) between February and July 2023 with consumers/carers/both ( n  = 11), clinicians (doctors/allied health/nursing/personal carers), hospital, health service and aged care leadership ( n  = 22), and public health stakeholders (n=4). Deductive framework analysis based on the PERCS implementation science framework was used. The following key determinants were identified: Enablers – strong executive leadership support; enthusiasm for expanding rural and remote services; need for a clear vision; strong tension for change; commitment to high-quality healthcare. Major barrier: restrictive funding models that stifle opportunities for innovation. Other barriers: technological limitations; communication challenges; workforce issues; clinicians’ opinions varied on safety and suitability of virtual healthcare. This implementation science approach enabled identification of a broad set of determinants not previously reported, relevant locally and for an international audience. Evaluation of implementation outcomes is necessary.