In the era of COVID-19, a patient in the intensive care unit of The Johns Hopkins Hospital now spends time with family members by video chat. Staff members deliver personal electronic devices dropped off for sick loved ones, and medical student volunteers call the patients’ contacts to explain how they can best stay informed about patients’ medical conditions when they are no longer permitted to visit them.
Thanks to the collaboration among the Johns Hopkins Medicine patient experience office, information technology (IT) and nursing, such efforts to keep hospitalized patients connected with their families and friends — and to stave off loneliness and boredom — are well underway at all Johns Hopkins Health System hospitals.
Since the new visitor policy took effect in late March — no visitors are allowed under most circumstances — the patient experience office has organized amenities that include virtual concerts from Peabody Institute musicians; guidance on how to use video, audio and texting apps created in partnership with Patient Education and IT; and consults with doctors that families can join remotely.
“This just tears at us because it’s the opposite of the years we’ve spent trying to open up visitation in hospitals,” says Lisa Allen, chief patient experience officer for Johns Hopkins Medicine. “We totally understand the need to stop the spread of the virus through physical distancing. It’s just really painful. We’re trying to think of all the ways we can keep patients and families connected.”
Staying in Touch During the Coronavirus Pandemic
The patient experience group across the system includes information desk and guest services staff, volunteer coordinators, patient relations employees, administrators and patient experience coaches who partner with other staff members on patient- and family-centered care. Since the arrival of the pandemic, the office has also collaborated more closely with volunteer services, marketing, spiritual care and unit providers in addition to patient education and IT.
“How do you take a very open visitor policy — we encourage loved ones to stay by the bedside 24/7 — and then move to what is essentially a no visitor policy?” Allen asks. “We’re doing as much as we can to make our communications devices work in a way so families can see patients, even if they [the patients] can’t talk, because we know it’s comforting.”
The majority of in-patient rooms are now equipped with a Johns Hopkins-issued tablet that has MyChart Bedside, a web browser and a video conferencing app. For the sickest patients — those in the intensive care unit — hospital-issued iPads will soon feature an app to help ward off delirium, as well as an app that allows patients who can’t speak to point to sensations like hunger, thirst and pain.
The patient experience office worked with marketing and IT to create a COVID-19 virtual resources guide that explains how to set up and use such apps as FaceTime, Google Hangouts, Skype and Zoom. It also includes instructions for setting up MyChart, a secure portal that patients and those with their permission can use to access medical records, and CaringBridge, a free blog platform used by patients and patients’ contacts to post health updates for friends and family.
Keeping Patients with COVID-19 Occupied, Families Updated
Whenever a new patient with COVID-19 is admitted, a clinical customer service coordinator — or a medical student volunteer who is working remotely — calls the patient’s primary contact to explain all of the available resources and ways to stay connected. Contacts learn which providers are in the patient’s medical unit, whom they can expect to call, when to expect updates and what they will entail, and what kinds of questions they may want to ask. They are also offered a call from hospital chaplains and social work and case managers.
The patient experience office also provides virtual entertainment for patients. Along with receiving a vetted list of websites that include visits to virtual zoos and national parks, a pilot program is available to patients at The Johns Hopkins Hospital from the Peabody Institute’s Sound Rounds program. Student musicians, who formerly performed in patient rooms, waiting rooms and hallways, now entertain via Zoom. Prerecorded concerts also air on the hospitals’ closed-circuit television station that also features the C.A.R.E channel’s programming of nature scenes and calming music.
For patients who just want to listen to music, Peabody musicians are creating playlists on Spotify, a digital music streaming service loaded onto patient tablets. Volunteers are available to explain how to use the app.
Other efforts under consideration include engaging volunteers to read books virtually to patients and finding ways to form virtual support groups for patients and families.
“It’s been very touching how many people have reached out to say, ‘How do we make sure our patients still feel the love? Not only love from us as care providers, but love from their family members even when they can’t be there,’” Allen says. “It’s painful to all of us, and we are looking forward to the day when we can get back to our 24/7 open policy.”