Rapid deployment of virtual ICU support during the COVID-19 pandemic

Abstract

The COVID-19 pandemic brought many serious challenges to the clinical workplace, and was a catalyst to novel approaches to the way in which we practice medicine. These challenges include extreme numbers of critically ill patients overwhelming many intensive care units, how to maintain the flow of communication between clinicians, patients and their families, and how to prevent the spread of infection working on quarantined units in personal protective equipment. The Royal Brompton and Harefield Hospitals deployed a series of digital solutions to try to address some of those challenges and a series of case studies describes their clinical application in three clinical domains: communicating with families, clinical communication between clinicians and the delivery of clinical education.

Developing an Innovative System of Open and Flexible, Patient-Family-Centered, Virtual Visiting in ICU During the COVID-19 Pandemic: A Collaboration of Staff, Patients, Families, and Technology Companies

“…We see variation in the type and set up of device used for virtual visiting (from mobile devices held by staff or mounted to stands, to existing bedside computers with mounted cameras, to existing telecritical care systems), the number and availability of devices used within units (from one device per patient, to one or a small handful of devices shared across the unit or hospital), and the manner in which virtual visiting is coordinated and facilitated (from a communication team often consisting of additional staff, to a re-purposed telecritical care coordination center, to bedside nurses). 13- 23…”

“…We see variation in the type and set up of device used for virtual visiting (from mobile devices held by staff or mounted to stands, to existing bedside computers with mounted cameras, to existing telecritical care systems), the number and availability of devices used within units (from one device per patient, to one or a small handful of devices shared across the unit or hospital), and the manner in which virtual visiting is coordinated and facilitated (from a communication team often consisting of additional staff, to a re-purposed telecritical care coordination center, to bedside nurses). [13][14][15][16][17][18][19][20][21][22][23] While there have been limited formal qualitative studies, the feedback about virtual visiting from patients, families, and staff is grossly positive. Patients are sent love and emotional support and are reminded of what waits for them when they get better.…”

Telemedicine Intensive Care Unit (Tele-ICU) Implementation During COVID-19: A Scoping Review

“…Studies in Israel and London described newly launched hospital infrastructure, including construction in the former and rearranging in the latter, to accommodate green and red zones, insulating in-house intensivists from infection and utilizing their advanced training and experience to direct operations [ 14 , 18 , 19 ].…”

Inpatient Telemedicine and New Models of Care during COVID-19: Hospital Design Strategies to Enhance Patient and Staff Safety

“…Telemedicine approaches allowed staff in quarantine or in high-risk groups (older, immunosuppressed) to work remotely during the surge [14]. In addition to remote home care, telemedicine was found to be ideally suited to meet the demands of inpatient care while at the same time reducing virus transmission, stretching human and technical resources, and protecting patients and healthcare workers in the inpatient care setting [3,19,20]. Inpatient telemedicine provided a solution to avoid physical contact with COVID-19 infected patients that significantly increases the chance of illness transmission and the need to quarantine exposed healthcare workers.…”