Implementing digital devices to maintain family connections during the COVID-19 pandemic: Experience of a large academic urban hospital.

INTRODUCTION: The COVID-19 pandemic lockdown imposed drastic measures at hospitals internationally to rapidly pivot their approaches to patient care. Early on when the pandemic was declared, hospitals responded to local public health restrictions by limiting all non-essential visits for their patients. Digital devices allowed Canadians to remain connected with their friends and families during the imposed isolation restrictions. The aim of this clinical perspective is to share the experience with the immediate implementation of digital connections for patients by exploring the impact as well as to describe key learnings from the initiative. METHODS: 150 iPads were distributed to clinical teams for use by patients, for either clinical care or for social connection. An iterative evaluation process, guided by quality improvement methodology, was followed which ensured that any changes to the iPad implementation process were responsive in real time. The evaluation measures included a clinician survey and collection of narratives from patients and clinicians. RESULTS: All clinician respondents (n=7) indicated that the iPads were a valuable tool to support patients and families. Narratives from patients indicated that virtual connections brought joy to them especially given that they were isolated from their support systems during the initial days of COVID-19. Key learnings for the Implementation Team were: the importance in maintaining cognitive stimulation as an enabler to recovery for patients; staff members provide support beyond direct clinical care; technology needs to be harnessed to facilitate clinical care; technology should be leveraged to support clinical care; and interprofesssional collaboration of the entire Implementation Team is a key enabler of success. CONCLUSION: Since implementation, iPads have been integrated as a supporting digital tool for both social connections as well as clinical care as a result of the benefits seen during this initiative. The iPads have also been recognized as a tool to complement patient connection and care and currently being expanded as part of services to patients, families and their clinicians.

Implementing the STEADY Wellness Program to Support Healthcare Workers throughout the COVID-19 Pandemic.

The COVID-19 pandemic has posed an ongoing threat to the mental wellbeing of countless individuals worldwide, with healthcare workers at particularly high risk. We developed the STEADY staff wellness program prior to the pandemic based on the available literature and input from stakeholders, guided by the Knowledge-to-Action (KTA) Implementation Science Framework. We quickly adapted the STEADY program for implementation in selected high-need units within Canada's largest trauma hospital during the pandemic's first wave. This brief report describes implementation of the STEADY program, retroactively applying the structure of the Knowledge-to-Action Implementation Science Framework to the practical steps taken. We identified the importance of more frequent, shorter contact with HCWs that occurred in-person, with an emphasis on peer support. A flexible approach with strong support from hospital leadership were key facilitators. Our findings suggest that a flexible approach to practical program implementation, theoretically underpinned in best-practices, can result in an acceptable program that promotes increased HCW wellbeing during a pandemic.

Optimizing the role of social workers in advance care planning within an academic hospital: an educational intervention program.

Advance Care Planning (ACP) promotes communication to help patients express future health-care preferences and goals for their medical care. Social workers (SWs) are trained to facilitate complex conversations and assist in various ACP tasks across clinical settings. This three-part mixed-method interventional study implemented a comprehensive education and training program for SWs of a large academic hospital, which used pre- and post-training evaluations, chart review, and qualitative data from debrief sessions to examine ACP skills and confidence, and assess the number of ACP conversations initiated with patients. Self-reported level of preparation to facilitate ACP conversations improved significantly (n = 26; pre 36% versus post 82%; p < .05). A 4-month post-intervention chart audit showed an 8.69 fold increase in the number of initiated ACP conversations. Qualitative analysis identified key themes regarding barriers and enablers of initiating ACP conversations during standard care from the perspective of SWs.