I am not sure how it happens in your ED, but from what I have heard and experienced, ED visits since the arrival of Covid-19 tend to be drop-offs. Patients who can make their way into ED on their own steam must do so unaccompanied by a family member or friend. Once inside the ED, there are some benefits to visiting during a pandemic. – it’s quieter, and fewer people are unknowingly sharing germs.
But as a patient, there are also many downsides – no support (emotionally or physically), no one to advocate or fill in background information, no one to translate, no one to be a runner for a drink or snack (if permitted) and no one to hear the diagnosis and treatment plan.
Dr. Kendall Ho, EM NetworkReal-Time Virtual Support Lead and digital health expert, recently conveyed a simple way to bridge that gap for patients, using basic technology. ED patients can use their phones to include a family member at key moments of their visit. For example, at the initial consult, diagnosis and next steps. It could be as simple as making a phone call, using the speaker function, doing a Facetime call, or whatever works most efficiently. Perhaps even patients could simply record the conversations so they could listen again if they need to.
From a patient perspective, I think it is a great idea and something you can suggest for your patients. It is a way to ensure that messages are heard clearly by another person who can support the patient, and it optimizes their ED visit. Patients in distress do not always hear all the details, and outcomes will be preferable if there is another pair of ears to listen in. Not everyone will arrive with a cell phone or with a full battery, but for those who do, why not support this option? To go one step further for patients without a phone, would it be possible where advantageous to bring in a department portable phone to include a family member on speaker? Patients can also be directed to EM Network Patient Information Sheets on their phones. This gives them on-demand access to their discharge instructions and eliminates the need to print out patient handouts.
I welcome any feedback or concerns about this suggestion. It would be great to hear ideas you’re employing in your hospital. Please comment below!
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Great post and suggestions Nancy! My personal view is that "the system" went (and continues to go) too far in demanding patients enter the ED alone. Virtually all EDs have policies allowing this policy to be waived for things like language barriers, confusion, or life threatening illness, but even now ED staff continue to be reluctant to allow a friend or family member in, even when circumstances warrant it and everyone is masked. In particular for the elderly, or those who are scared, having a familiar person at the bedside makes a huge difference for both the patient and the providers, and could easily be more supported than it is... In the meantime though, what you propose is very helpful Nancy, so thanks again for that. One technical challenge is that many EDs have "dead zones" where cell phones don't work. All the more reason for ED care providers to keep what you proposed in mind, and even initiate this ourselves with ED portable/speaker phones whenever it would be helpful.
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Great post and suggestions Nancy!
My personal view is that "the system" went (and continues to go) too far in demanding patients enter the ED alone. Virtually all EDs have policies allowing this policy to be waived for things like language barriers, confusion, or life threatening illness, but even now ED staff continue to be reluctant to allow a friend or family member in, even when circumstances warrant it and everyone is masked. In particular for the elderly, or those who are scared, having a familiar person at the bedside makes a huge difference for both the patient and the providers, and could easily be more supported than it is...
In the meantime though, what you propose is very helpful Nancy, so thanks again for that. One technical challenge is that many EDs have "dead zones" where cell phones don't work. All the more reason for ED care providers to keep what you proposed in mind, and even initiate this ourselves with ED portable/speaker phones whenever it would be helpful.