This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
1. Assess whether there is a need for restrictions to family based on current factual evidence. Continually reassess and adjust policies as conditions evolve.
2. Minimize risk of physical presence by following appropriate infection control guidelines issued by the World Health Organization (WHO) and local and regional health authorities.
3. Communicate what to expect proactively and with compassion so families do not appear at a facility unaware of restrictions that have been put into place.
4. Establish and clearly state compassionate exceptions to family presence restrictions, for example in end-of-life situations.
5. Support meaningful connections to minimize isolation in cases where family is unable to be physically present, using virtual or other means.
6. Inform and educate in cases where family can be with their loved one physically, adopting a shared decision-making approach to communicate the risks and benefits.
7. Enlist family as partners for quality and safety, engaging them as members of the care team who share in the responsibility for abiding by established safety protocols.
8. Enhance discharge education and post-discharge follow-up to support successful transitions of care, especially when family have not been present during a hospitalization.
Rivas Zorggroep– Hospital Care, Rehabilitation Elderly People, Home Care, Nursing Homes– The Netherlands, Rotterdam area, 4000 employees– Nursing Homes Rivas: 1000 residents elderly people in 17 Nursing Homes– Planetree Gold Certified for Excellence in Person-Centered Care
Context: • In the Netherlands, people with dementia and somatic diseases stay 2 years in nursing
home before death (average)• Nursing Homes are capable of low and medium medical care
Timeline • March 18th Nursing homes were closed for visit of family (government policy)• April Rivas made a national Guideline “Visiting Policy Nursing Homes”
– Guideline was made to develop an alternative to government policy to close all nursing homes in the Netherlands
• May 11th A nursing home of Rivas is one of 25 pilots for restart visiting • May 25th each Nursing Home in Netherlands without Covid 19:
– one visitor per resident a week; symptom and temperature screenings at entry; masks and instructions on physical distancing provided at entry
– Following the containment of community spread and decreasing cases
• June 15th two (non unique) visitors per resident a week• July 1st more visits a week, screenings at entry and testing policy
Challenges to maintaining a person-centered approach to family presence
• In last months of life, family presence is essential for human dignity– Residents autonomy and free choice VS governments safety perspective– Families that want liberal policy VS families that want to keep all safety measures– Employees that want liberal policy VS employees that want to keep all safety
measures
Context: In society there is more flexible policy (public transport, schools, sports, restaurants, holidays. -> not explainable to families and residents
• Griffin Health Services– 160-bed acute care community hospital with 1,000 employees located in southern
Connecticut, USA– Located approximately 70 miles from New York City– Planetree Gold Certified for Excellence in Person-Centered Care
• COVID-19 experience– Treated over 170 COVID-19 hospitalized patients between March – June 10th– Community spread of the virus is now contained in the region
• Griffin has had a patient-directed visitation policy for over 20 years, with patients choosing who/when visitation occurs
• Care Partner program has been in place for over 15 years• COVID-19 policy changes included:
– One visitor at a time for non-COVID patients for both the E.D. and inpatient, exceptions on the number of visitors were made for humanitarian and end of life situations, allowing for more than one visitor at a time
– Symptom and temperature screenings as well as masks and instructions on physical distancing provided at entry
– For COVID-19 patients, visitors were not allowed, with exceptions made for humanitarian and end of life situations
Challenges to maintaining a person-centered approach to family presence
• Women in labor coming from other regions, including NYC, arriving at the hospital wanting to receive care at a person-centered facility that allows a birth partner
• Families familiar with Griffin’s person-centered model of care expecting more liberal family presence policies even during the crisis
• Area residents who usually use another regional hospital deciding to access care at Griffin due to the perception that it is safer than more restrictive hospitals.
• Base your policy decisions on facts as they emerge. If you have community spread under control, and access to screening and PPE, then why would you limit family presence?
• Recognize that a hospital’s visitor policy creates a consumer perception about facility safety which has implications as to whether consumers continue to avoid using hospital services due to fears about COVID-19 exposure
Public Opinion Strategies conducted a survey to assess public perception of the U.S. Healthcare system. The study was conducted during the period of April 16 – April 20. It was a national online survey of 1,000 adults.
Asked to rank on a 10-point scale how safe they feel going to a medical facility right now, half of respondents said 5 or below, with a mean score of 5.4. More than a third (37 percent) said
“feeling unsafe in a hospital setting” may be an obstacle to seeking future elective treatment.