Perspectives on Telephone and Video Communication in the Intensive Care Unit during COVID-19

Abstract

Rationale: During the coronavirus disease (COVID-19) pandemic, many intensive care units (ICUs) have shifted communication with patients’ families toward chiefly telehealth methods (phone and video) to reduce COVID-19 transmission. Family and clinician perspectives about phone and video communication in the ICU during the COVID-19 pandemic are not yet well understood. Increased knowledge about clinicians’ and families’ experiences with telehealth may help to improve the quality of remote interactions with families during periods of hospital visitor restrictions during COVID-19. Objectives: To explore experiences, perspectives, and attitudes of family members and ICU clinicians about phone and video interactions during COVID-19 hospital visitor restrictions. Methods: We conducted a qualitative interviewing study with an intentional sample of 21 family members and 14 treating clinicians of cardiothoracic and neurologic ICU patients at an academic medical center in April 2020. Semistructured qualitative interviews were conducted with each participant. We used content analysis to develop a codebook and analyze interview transcripts. We specifically explored themes of effectiveness, benefits and limitations, communication strategies, and discordant perspectives between families and clinicians related to remote discussions. Results: Respondents viewed phone and video communication as somewhat effective but inferior to in-person communication. Both clinicians and families believed phone calls were useful for information sharing and brief updates, whereas video calls were preferable for aligning clinician and family perspectives. Clinicians and families expressed discordant views on multiple topics—for example, clinicians worried they were unsuccessful in conveying empathy remotely, whereas families believed empathy was conveyed successfully via phone and video. Communication strategies suggested by families and clinicians for remote interactions include identifying a family point person to receive updates, frequently checking family understanding, positioning the camera on video calls to help family see the patient and their clinical setting, and offering time for the family and patient to interact without clinicians participating. Conclusions: Telehealth communication between families and clinicians of ICU patients appears to be a somewhat effective alternative when in-person communication is not possible. Use of communication strategies specific to phone and video can improve clinician and family experiences with telehealth.

The Experiences of Family Members of Ventilated COVID-19 Patients in the Intensive Care Unit: A Qualitative Study

“…In order to counteract this issue, video calls were introduced to facilitate communication between patients and family members when they were restricted from seeing their loved ones in the hospital. 18 - 20 However, in this study we found that many family members were shocked and felt more stressed after they saw their loved ones intubated, sedated, and connected to the ventilator.…”

Conditions and strategies to meet the challenges imposed by the COVID-19-related visiting restrictions in the intensive care unit: A Scandinavian cross-sectional study

“…ComunicoCOVID, 2020 , EU, 2021 , Kanaris, 2021 , Kennedy et al, 2021 , Scelsi, S., 2020 , WHO, 2021 , Ågård and Harder, 2007 .…”

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

“…Specifically, these suggestions included positioning the camera so that the family can see the patient and their surroundings, offering families the opportunity to ask questions about tubes and devices, and offering time for patients and families to interact without clinician participation. 24 …”

“…Specifically, these suggestions included positioning the camera so that the family can see the patient and their surroundings, offering families the opportunity to ask questions about tubes and devices, and offering time for patients and families to interact without clinician participation. 24 While these areas of improvement pertain to the particular model of virtual visiting used by Sasangohar 25 We know of the constellation of adverse phycological outcomes that can occur in ICU patients and their families, termed ICU trauma and post-intensive care syndrome-family respectively. [26][27][28][29][30][31] We also know that providing open and flexible visiting has the effect of reducing the risk of developing such outcomes.…”