Virtual visits are a safe way for families to stay in contact with hospitalized patients during the coronavirus pandemic.
AdventHealth is connecting hospitalized patients and families with virtual visits, including coronavirus patients.
To curb the spread of coronavirus disease 2019 (COVID-19), hospitals across the country have placed strict limits on visits to hospitalized patients. Visitation restrictions have been troublesome for COVID-19 patients, with families unable to see their loved ones for many days or weeks, and seriously ill patients dying without contact with their families.
For COVID-19 patients, virtual visits at AdventHealth have generated significant benefits, says Pam Guler, MHA, vice president and chief experience officer at the Altamonte Springs, Florida-based health system. "This has been meaningful for our patients, their families, and our caregivers. Many caregivers have told stories of creating a moment that has deep meaning not only for families and patients but also has touched their hearts."
AdventHealth features nearly 50 hospitals in nine states. During the COVID-19 pandemic, physical visits to hospitalized patients have been limited to a single loved one in the case of an end-of-life situation, childbirth, and a child in the hospital.
Virtual visit basics
AdventHealth recently launched virtual visits for hospitalized patients with the distribution of 1,000 Chromebooks and some iPads throughout the health system's hospital campuses, Guler says. The cost of the initiative was minimal because the Chromebooks were already in hand for another project, which has been delayed, she says. "The investment has been more about helping our team members to understand what they need to do."
With help from the health system's information technology staff, Guler has a team of 65 experience leaders who facilitate the virtual visits. In one recent week, the health system conducted 1,350 virtual visits. "Our information technology staff loaded the Chromebooks in a way to make it as easy as possible to use Google Hangouts, Facebook Messenger, and Facetime. We are using Google Hangouts quite a bit for video chats."
Coronavirus patient virtual visits
AdventHealth has put protocols in place for hospitalized COVID-19 patients to have virtual visits with loved ones, including for end-of-life situations, Guler says.
There are three primary considerations for virtual visits with all COVID-19 patients:
- To limit the number of people in a patient's room for infection control, a bedside caregiver in full personal protective equipment brings a Chromebook or other device into the room
- The device can be held by the bedside caregiver or placed on a bedside table if the family requests privacy for the virtual visit
- After the virtual visit, a disinfectant is used to sterilize the Chromebook or other devices
The protocols for end-of-life situations are more involved, she says. "We have to facilitate calls more when there is an end-of-life scenario and the patient is not able to be an active participant."
The first step is for an experience leader to contact the family and to see whether they want to have a virtual visit. Then the family is asked whether they want to have a hospital chaplain included in the virtual visit.
Once a virtual visit has been arranged, an experience leader initiates the call to the family and hands off the device to a bedside caregiver outside the patient's room. In most cases, the bedside caregiver holds the device so the family gets a full view of the patient.
Although ICU bedside caregivers are experienced in working with the families of dying patients, they have received training to help them facilitate virtual visits, Guler says.
"This is a very deep and meaningful situation and interaction, and we have shared some words the caregivers might say. They may ask the family whether there is anything they can do to be the family's hands as the family is talking with their loved one, such as, 'Can I touch your loved one's hand?' They have protective equipment on, but they can be the hands of the family. The caregivers try to do anything they can to bring a human touch to this virtual experience."
Many family members can participate in an end-of-life virtual visit, she says.
"In one end-of-life situation, we had 15 family members on the virtual chat, along with their family pastor. The patient could not respond, but the family was able to say some last words. They said how much they loved the patient. Their pastor prayed with them. It was deeply meaningful and facilitated by a caregiver who held the device. In that situation, the caregiver did not need to say anything."
The new normal
AdventHealth plans to continue providing virtual visits for hospitalized patients after the COVID-19 crisis is over, Guler says.
"We want to continue virtual visits in the future. Even in a non-COVID-19 scenario, we often have patients who have family across the country. With this platform now in place, contact does not just have to be through telephone. We are already exploring ways that we can have virtual visits in the future in a non-COVID-19 world."
Christopher Cheney is the senior clinical care editor at HealthLeaders.
In response to hospital visitation restrictions put in place during the coronavirus pandemic, AdventHealth recently started virtual visits for all patients.
For coronavirus patients, several protocols were established to make sure the virtual visits are safe for hospital staff.
For coronavirus patients in end-of-life scenarios, virtual visit protocols include offering to have a hospital chaplain participate in the call.