Purpose/Aims Development and implementation of a predictive analytic scoring system in a system of 21 hospitals required 24-hour surveillance to ensure alerts were responded and acted upon. Identification of gaps in patient care created an opportunity to innovate and develop a team to integrate both workflows.

Description of Project/Program A Virtual Nurse team of master's degree–prepared nurses with backgrounds in intensive care and management led by a clinical nurse specialist work remotely from their homes. Each nurse is assigned to either of 2 workflows: Advance Alert Monitor—predictive analytic scores or e-Hospital involving capturing of care gaps. The Virtual Nurse team covers 24 hours a day/7 days a week.

Outcomes The program has resulted in 169 lives saved and an observed-to-expected mortality of 0.8. Improvements in standard workflows across the system have enabled Rapid Response Teams to be implemented in each hospital.

Conclusions The success of the Virtual Nurse team has resulted in developments to spread the program into other Kaiser Permanente regions. The Virtual Nurse team has grown to 40 nurses and will expand as the program spreads.