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How one hospital is using remote technology to foster relationships with COVID-19 patients

Patient and staff morale has improved following implementation of a personalized, virtual rounding program intended to foster connectedness.

Jeff Lagasse, Associate Editor

One of the saddest aspects of the COVID-19 coronavirus pandemic has been the separation of hospital patients from their loved ones. In an effort to prevent the spread of the disease, hospitals across the country are banning visitors, forcing patients to undergo treatment without the support of family and friends.

For these patients, the need for human connection has never been more pressing or urgent. UChicago Medicine realized this, and began implementing a virtual rounding program that is helping patients develop personal relationships with their caregivers -- alleviating their feelings of isolation as they're treated under quarantine and barred from receiving visitors.

The concept is simple: Virtual rounding uses mobile video streaming technology to connect patients and caregivers. Each has access to tablets, which allow them to connect digitally when they can't connect physically.

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Indirectly, this is also helping COVID patients maintain contact with their loved ones, as families now have a means of delivering messages to their stricken relatives.

The focus of the initiative is to provide feelings of safety and comfort to both COVID and non-COVID patients alike, and to give nurses and other care staff the tools they need to address patients' fears and concerns.

In a way, the virtual rounding program is an extension of the hospital's overall philosophy. For years, caregivers would go into a patient's room and ask them a series of questions in an attempt to develop a relationship with them. When the pandemic started to spread and accelerate, leadership knew they had to change the way staff interacted with patients, and after suspending family visits, the iPads came out in force.

"We asked, 'What could we do differently to continue a connection with patients?'" said Susan Murphy, UChicago Medicine's chief experience and innovation officer. "We understand the clinical needs, but there are also human needs. If we weren't connecting with patients, they would be very vulnerable."

The virtual rounds take place seven days a week and have become more personal in nature. But what has made the approach novel is that patients are consistently matched with the same caregivers, which allows them the time to develop a relationship.

"We decided to have the same person call the same patient every day, both COVID and non-COVID patients," said Murphy. "Relationships started to be built -- everything from, 'Is your phone charged?' to, 'How was your vacation last year?' It's the outreach that has really made a difference."

This resulted in a few workflow tweaks for care staff, but the buy-in was almost immediate. Some of the hospital's staff is now working from home, but with access to iPads and additional training, even they can get in on the act, identifying patients who may be in need of certain things -- everything from bedpans to chaplains -- and helping those patients in a streamlined manner.

POWER TO THE PATIENTS

Importantly, patients have a say in when they prefer to have these digital interactions. The decision of when to talk is a shared one, which gives the patients a level of control over the process, and ensures they can make those connections at times when it's good for them.

"COVID-positive patients are afraid they're going to get someone sick," said Murphy. "As much as the clinical team is doing a beautiful job, what we earned is this call gives them an opportunity to express their fear.

"Also, they want to thank people so much, they just didn't know how to do it. When these people walk into the room with all this PPE on, they don't know who to thank or how to do it. They can now. That's very meaningful for these patients in the room."

While patients now find it easier to give their thanks to specific personnel, the staff members themselves have also benefited. Healthcare workers on the front lines of the pandemic are under near-unfathomable levels of stress, and hearing words of gratitude and encouragement from the people they're treating has kept spirits lifted at a time when it's needed.

"When people are waiting to go into the COVID unit, there's an entry area where you walk in to put on your PPE," said Murphy. "When a time is very active, there could be some people standing and waiting for a group to finish, so they have to wait to put on their PPE. We put a TV monitor in the room before they walk in, so while they're waiting to go into those rooms, they see comments from patients.

"They all need that feedback," she said. "Because of this program, it's very specific. You can put up a banner that says, 'Thank you all,' but we're putting up quotes from patients that are very unique and individualized, not just 'Thank you for what you're doing.'"

Of course, what patients still lack is face-to-face time with their family and friends. There's no true substitute for that, but family does have the option of connecting with their ill relative's caregiver to send along messages of love, encouragement and hope. Times are dark, but that's at least one more glimmer of light.

For other organizations interested in pursuing a similar program, Murphy recommends finding a good technology partner and to start on a smaller unit to see if there are wrinkles that need to be ironed out. It doesn't have to be perfect to begin with; the important thing is just to start.

"We find these rounds incredibly powerful," said Murphy. "We're creating personal moments of connection."
 

Twitter: @JELagasse

Email the writer: jeff.lagasse@himssmedia.com