April 10, 2020
Health systems across the Philadelphia have instituted strict no-visitor policies, with some limitations, amid the COVID-19 crisis in an effort to protect patients and staff.
Those policies are in accordance with guidelines issued by the Pennsylvania Department of Health. They affect families of all patients – not just those battling coronavirus infections.
While a necessary measure, these policies can cause extra anxiety for the families of patients, says Kay Van Wey, a patient safety advocate and personal injury lawyer in Dallas, Texas. She offers a few tips to help family members advocate for any loved ones in the hospital – even if they can't be at their bedside.
Connecting with loved ones and communicating with their care providers are essential during public health emergencies, Van Wey said.
Her first suggestion is getting the patient a smartphone with FaceTime capability – if they don't already have one – and sterilize it. This will help family members stay connected
Next, she advises asking the nurse to write the contact information of a family member on the whiteboard in the patient's hospital room and at the nurses' station. Include a reminder to call anytime the doctor enters to see the patient. Being a part of these visits will allow family members to correct any possible miscommunications.
"Find out who the quarterback is, usually a hospitalist, although that could be changing, so you know who to talk to," she said.
Van Wey generally advises against relying on Google searches for medical information. But looking up information on common conditions – like congenital heart failure – can help family members understand the critical markers of the disease and identify questions to ask providers.
"Ask upfront what you can expect communication wise," Van Wey said. "How many times a day can you expect a call?"
For patients who cannot communicate themselves – like some in critical condition – it is especially crucial for their health care designee, usually a spouse or parent, to receive updates on any changes to the patient's health.
"Patient advocacy is always important, but more so now because you can't be in the hospital with them," Van Wey said.
Like other health systems in the region, Temple Health is following state guidelines to restrict visitors with limited exceptions – like end of life or certain clinical situations.
Chief Experience Officer Dwight McBee, who oversees visitor management and patient advocacy, acknowledged that it can be very challenging to advocate for a patient under the guidelines.
"Temple Health encourages the use of video conferences, FaceTime and virtual visits to stay connected," McBee said. The health system recently received a donation of iPads for their patients to use.
"I still recommend old-school writing letters and sending cards," he added.
McBee advised family members to choose a spokesperson, preferably one with some medical knowledge, to communicate with a patient's clinical team. Additionally, he encouraged family members to record reminders for their loved ones, so that they can remember to ask critical questions during their care.
Audio and video conferences with the clinical team are facilitated for the patient's family members, and in situations where decisions need to be made, visitors are permitted in the hospital. But they first may be subjected to a screening and temperature check.
Asked how frequently family members can expect communication from the clinical team, McBee said "decisions are made on a case-by-case basis and depends on the complexity of the care needed for the patient."
If patients are stable enough to speak for themselves, only daily check-ins may be necessary, McBee said. But when patients are in critical condition, the clinical team will call the patient's medical care designee every hour, if needed.
Additionally, Temple Health supports spiritual visits for patients through volunteer chaplains.
Jefferson Health has adopted similar visitor restrictions amid the coronavirus pandemic. Chief Operating Officer Stephanie Conners said the health system continues to emphasize the importance of compassionate care.
"Most importantly we feel that as life enters and leaves the world, we have to take care of the whole person," Conners said. "As crucial as it was to limit visitors, we did make the important decision to allow one partner with a birthing mom, and at the end of life."
Though Jefferson Health is trying its best to allow a loved one to say goodbye at the bedside, she cautioned that no health system can guarantee someone can get to the hospital in enough time.
Like Temple, Jefferson is providing iPads to patients so they can FaceTime with their families.
"We don't feel that isolating yourself means isolating from family members," Conners said. "We make every effort to ensure they stay connected."
And when it comes to communicating with staff, she said every change in the status of a patient is communicated with the patient's designee in real time.