With visitors temporarily barred from hospitals, physicians across the country are using video apps to meet with family members to offer clinical updates or discuss end-of-life preferences for critically ill patients.
South Shore Hospital, part of South Shore Health, in South Weymouth sought a new way to enable this important communication via FaceTime or Zoom while also easing the physical and emotional workload for hospitalists and intensivists caring for the spike in patients with COVID-19.
Now, the hospital is tapping a pool of clinicians who took on temporary assignments after COVID-19 forced suspension of elective surgeries and many outpatient visits. Re-deployed in intensive care and other units, they help their colleagues keep families connected at critical moments. All bring skills that can help bridge communication gaps.
Karin Sloan, M.D., a pulmonologist and Associate Medical Director of Ambulatory Care at South Shore Health, leads the Communication Liaison Provider program, which is focused on giving clinical updates to patients’ families and discussing goals-of-care with them when appropriate. The Patient and Family Connectors team, led by Susan Romano from the hospital’s Patient Experience Office, coordinates social video calls between patients and families. They also help troubleshoot technical issues with video calls for both teams.
“Our team has seen a lot of sadness,” Sloan says. “These are powerful experiences. Our team members hold the iPad so families can say their goodbyes, with lots of tears shed. It's been pretty amazing. It takes a certain type of person to be able to do this work.”
Sloan’s team serves the communication needs of patients on the medical floor and intensive care units. They collaborate with hospitalists, intensivists, bedside nurses, and palliative care. The hospital’s social worker and chaplain also help, and two retired clinicians have joined the effort. One, a pulmonologist whom Sloan knew would add deep communication skills to the team because he retired from medicine to become a church deacon, also recruited a retired advance practice clinician to join the effort.
The re-assigned clinicians get orientation, training, and ongoing support. Sloan says, “We don't just throw them in. In addition to training on donning and doffing PPE, logistics, and serious illness conversation skills, we have a daily half-hour meeting to provide a support network.” They work in groups of three on a three-days-on, four-days-off rotation. A variety of specialties are represented, including several PCPs, a radiologist, an emergency physician and surgical physician assistants.
After only six weeks, the approach is now seen as an indispensable way to involve patients’ loved ones in care, regardless of mobility or location, during the COVID-19 crisis and beyond.
Sloan and Romano are just beginning to think about how to sustain this work as their colleagues begin to return to their pre-COVID specialties. Reflecting on the past few weeks, Romano says, “I feel like these people are now part of my department. I will be devastated when they go back to their real jobs!”