The Benefits and Risks of the Provision of a Hospital-Wide High-Definition Video Conferencing Virtual Visiting Service for Patients and Their Relatives

Abstract

Background Since the start of the coronavirus disease 2019 (COVID-19) pandemic, virtual visiting (VV) has become important because of visiting restrictions in hospitals. This project aimed to determine the impact of VV on staff and patients’ loved ones (visitors). Methodology VV is defined as high-resolution video communication between admitted COVID-19 patients and their loved ones in the presence of a staff member using a healthcare platform. VV was introduced in a 419-bedded hospital in the UK in April 2020. Qualitative data on the VV experience were collected from relatives and staff via an open feedback email address and reflective practice. Data were entered and analyzed in person by two independent assessors. Grounded theory methodology and thematic analysis were used to draw conclusions. Results Between April 16, 2020 and November 30, 2020, 1,009 visits were delivered. There were 138 feedback responses; 108 (78.3%) from relatives and 30 (21.7%) from staff. The amalgamation of data was resolved into five themes: appreciative factors (129, 93.5%), organizational skills (44, 31.9%), palliative care (38, 27.5%), staff communication (14, 10.1%), and VV process issues (11, 7.9%). A total of 131 (94.9%) responses had positive comments (111 from relatives, 20 from staff); negative comments were greater in the staff cohort (23%) than the relative group (4%). Trends included sub-themes in overwhelming emotions, emotional strain for staff members, and difficult situations. Conclusions VV in hospitals is a new and valuable way to connect patients with loved ones with mostly positive consequences. VV also has risks to mental health and well-being, particularly for healthcare workers facilitating the call.

Harnessing New and Existing Virtual Platforms to Meet the Demand for Increased Inpatient Palliative Care Services During the COVID-19 Pandemic: A 5 Key Themes Literature Review of the Characteristics and Barriers of These Evolving Technologies

“…The success of virtual inpatient palliative care relies on detailed training and support for staff to ensure it is a less straining experience. 6 In conclusion, virtual inpatient palliative care is an accessible and acceptable option during pandemics for most patients, family, and staff. The literature supports that a variety of inpatient palliative care services, including EoL support, goals-ofcare conversations, and other counseling, are feasible in a virtual format.…”

“…In each article, most patients and staff endorse that virtual inpatient palliative care is an acceptable alternative to inperson services, with percent acceptability ranging from 70%-100%. 3,[6][7][8][9][10] This is because virtual inpatient palliative care has been shown to improve the death and dying experience for patients and their families during the pandemic by bridging the isolation gap safely, and increasing one's sense of empowerment and ability to cope with adversity. 11 In one satisfaction survey, 97.1% of palliative care patients and 100% of caregivers felt comfortable having sensitive conversations over video, 3 and offering virtual connection solutions increased patients' access and desirability to go to hospice during the pandemic.…”

“…16 Costs associated with transportation, local orientations, and mask fit testing are also reduced. 17 It is important to note that while patients and their loved ones were generally impressed with the quality of care provided on a virtual platform, 6,9,12 23% of the staff cohort in one study reported risks to their mental well-being when facilitating inpatient family e-meetings. 6 Many workers bore witness to grief in the patient-family interactions that would normally be private 6 and this repeated exposure to trauma can be draining.…”

“…17 It is important to note that while patients and their loved ones were generally impressed with the quality of care provided on a virtual platform, 6,9,12 23% of the staff cohort in one study reported risks to their mental well-being when facilitating inpatient family e-meetings. 6 Many workers bore witness to grief in the patient-family interactions that would normally be private 6 and this repeated exposure to trauma can be draining. 18 Combined with challenges in setting up and learning to use the equipment, some staff resisted adjusting to these changes.…”

“…27 While popular commercial solutions like WhatsApp TM , FaceTime TM , Zoom TM were used in some studies, these platforms may be incompatible with hospital cybersecurity domains. 6 Dedicated HC platforms are sometimes needed, with a common example being Attend Anywhere TM . This platform prevents screen recording by receivers and offers multiple inprogram language translations to aid in difficult conversations with patients whose first language is not the same as the care provider.…”