Hospital visits in today’s environment are like nothing you have encountered before. Under most circumstances in the past, you would expect a family member to accompany the patient to an ED visit or admission. But due to COVID-19 , new visitor policies pose a huge challenge for patient/family engagement.
Recently I had the opportunity to experience what is like to have a family member in the hospital during the pandemic. My experience started as we drove up the ED ramp of our local Trauma Center and were greeted by a Hospital guard and a nurse while still in my car. After a couple of questions, they took my husband into the ED immediately. I waited on the ED ramp in my car. After a few minutes, I flagged another nurse that was standing in a “makeshift” triage station by the ED doorway. She came to the driver’s side and I asked her where I could wait while my husband was being treated. She simply said I could wait in my car by the ED parking lot or in the hospital’s garage. It is hard to prepare for this feeling, even as a healthcare provider. The visitor rules do not sink in until you are at the door or on the other side of it. Your family member will be cared for and will interact with some of the healthcare heroes on the front line. You, however, will wait and hope for a phone call from a nurse or doctor.
I have years of experience navigating the healthcare system that most of our patients and families do not have. Despite this advantage, my experience tells me that providers must remain vigilant about focusing on the patient and family experience. Whether we use the incredible technology at our disposal or find other innovative communication models, there must be an effort to bring back the “personal touch” and “care” into the post-COVID health care setting.
My experience evidenced the need to develop a comprehensive and deliberate communication protocol for families and friends. The task is simple- to keep them informed and reassure them that their family member is in good hands. The pandemic is not going away any time soon. I suspect we will be dealing with these new visitor protocols for several years to come. Knowing that the current state will not change anytime soon, we need to reassess how we communicate with our families and develop new mechanisms to compensate for the lack of in-person communication and touch.
During my husband’s hospital stay I never received a call from a provider. I initiated all the communication. I made sure my husband had a cell phone so that I could communicate with him. Obviously, this worked for me because he was not debilitated and could use and charge the cell phone. He was admitted to the 23-hour Observation Unit. Once he was settled, he called, and I asked him to take a picture of the “white board” in his room and send it to me. I knew the “white board” would have vital information such as where his room was located (he had no idea where in the hospital he was) and the nurse’s name, PTC’s name, and the telephone number to the nurse’s station. I called the nurse’s station and introduced myself to the assigned nurse. She was wonderful and nice enough to go into his room while she was on the phone with me. She informed me of the tests he was scheduled for and said I could call her anytime. I asked her to leave a note on the EHR for the assigned Hospitalist to call me and give me an update on my husband’s care. She gave me the Hospitalist’s name and Hospitalist Service name. I emailed and called the Hospitalist Service and requested that I be called. Upon my husband’s discharge, when the Hospitalist was explaining the results of his tests and the next steps in his care, my husband asked the Hospitalist if he could call me while she was explaining the results of his hospital stay so I could listen. The physician declined and said she would call me later in the day. I am still waiting. . . he was discharged over a month ago. I know how busy these providers are, I was one of them at one time, but it is totally unacceptable to never receive a call back! I cannot tell you my disappointment.
So, what do I do about this? This experience has given me the opportunity to think through how we need to prepare our nurses and providers to deliver care under the “new normal.” Not only do we need to revamp our patient engagement methodology, but we need to place more focus on family communications. New scenarios require new solutions. We need to be sure that our providers (physicians and advanced practice providers) are involved in the communication solutions and held to the best standard of care, even if they are not employed by the same organization.
We at Envision Better Health, LLC have devised a check list along with communication models for patient care updates that will have a minimal economic impact but will improve Patient and Family Engagement.