Peer feedback – Megan

The question I asked after the presentation: Given the crisis of staffing shortages in health care, especially in the emergency department. How can you address this barrier to get nurses into these roles and ensure feasibility?

Kennedy responded thoughtfully and thoroughly, while acknowledging the ongoing crisis of staffing shortage within the emergency department (ED), noting how it perpetuates overcrowding. Kennedy recognized that this issue is complex and affects all healthcare settings across the province. She highlighted that while there is government funding and education initiatives to increase nursing seats, this alone cannot resolve the staffing crisis. She explained that virtual roles could be appealing to some nurses because it offers flexibility and work-from-home options, which may open new staffing possibilities. Kennedy emphasized that staffing shortages remain a “wicked” problem without a simple fix. Her response aligned well with her presentation’s focus on reducing overcrowding and burden at Kelowna General Hospital (KGH). Kennedy communicated clearly and reflective in her response.

Kennedy’s presentation was well organized and visually clear. She integrated strong evidence from her article, Kelly et al (2023), on Australia’s Virtual ED pilot and connected it effectively to KGH ED. Kennedy explained how virtual triage targets the input stage of the ED flow demonstrating her understanding of the interconnections of the health care system. Kennedy presented professional with a calm tone and clearly summarized both strengths and challenges of the model. The visuals in the PowerPoint were engaging, with balanced text and colour, making the aids easy to follow.

1. 1. Providing further context into the crisis of Emergency Department (ED) at Kelowna General Hospital (KGH). Kennedy mentioned the overcrowding at KGH ED; however, this presentation could have been stronger by providing data into the crisis such as wait times and patient volume.
   2. Addressing the implementation specifics such as expanding on how staff would be trained, supported, and retained as well as the financial barrier within the virtual model would strengthen feasibility and realism.

1. 1. Adding  Kelowna specific data: include statistics about KGH ED wait times and staffing pressure to show the local severity of the wicked problem and then relate it to broader Interior Health trends.
   2. Address implementation of workforce strategies: discuss the flexibility of scheduling and remote options. Integrating other disciplines into this role such as nurse practitioners (NP) and paramedics alongside of nurses in virtual triage role, as this does not just limit this to nursing.
   3. Plan for financial sustainability: It was addressed how funding can be accessed through the KGH foundation as well as grants; however, these are helpful for start-up costs like the kiosks and tech. The barrier remains on funding for ongoing positions. Interior health is not creating any more positions due to budget constriction, it would be beneficial to gather data for how virtual triage will decrease expenditures. With the research of decreasing overcrowding to the ED this will then allow nurses to move positions to fill the virtual clinic needs.
   4. Clarify technology access- Address barriers for older adults and those without reliable internet. The idea of Hospital kiosk may be less useful than a community-based kiosk/hubs, especially for rural communities where access is a challenge.
   5. Education implementation: Staff will require structured education and resources to operate the new virtual triage safely. Incorporating iLearn modules and simulation labs could provide realistic training, build confidence, and standardize practice across staff.