Rachel Everitt1, Aaron K Wong1,2,3, Olivia Wawryk4, Brian Le5,6, Jaclyn Yoong7,8, Maria Pisasale9, Ruwani Mendis10,11, Jennifer Philip1,3,12. 1. Parkville integrated Palliative Care Service, The Royal Melbourne Hospital, Melbourne, Victoria, Australia. 2. Palliative Care Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. 3. Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia. 4. Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia. 5. Parkville Integrated Palliative Care Service, The Royal Melbourne Hospital, Melbourne, Victoria, Australia. 6. Department of Medicine RMH, The University of Melbourne, Melbourne, Victoria, Australia. 7. Palliative Care Service, Northern Health, Melbourne, Victoria, Australia. 8. Monash Health, Monash University, Melbourne, Victoria, Australia. 9. Palliative Care Service, Werribee Mercy Hospital, Melbourne, Victoria, Australia. 10. Palliative Care Service, Western Health, Melbourne, Victoria, Australia. 11. Department of Medicine, Western Health, University of Melbourne, Melbourne, Victoria, Australia. 12. Palliative Care Service, St Vincent's Hospital, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: COVID-19 has led to challenges in providing effective and timely communication in healthcare. Services have been required to adapt and evolve as successful communication remains core to high-quality patient-centred care. AIM: To describe the communication between admitted patients, their families and clinicians (medical, nursing, allied health) during end-of-life care. METHODS: This retrospective review included all patients (n = 230) who died directly due to COVID-19 at five Melbourne hospitals between 1 January and 31 December 2020. Contacts and modality used (face to face, video, telephone) during the 8 days prior to death were recorded. RESULTS: Patients were predominantly elderly (median age 86 years) and from residential aged care facilities (62%; n = 141). Communication frequency increased the closer the patient was to death, where on day of death, contact between clinicians and patients was 93% (n = 213) clinicians and families 97% (n = 222) and between patients and families 50% (n = 115). Most contact between patients and families was facilitated by a clinician (91.3% (n = 105) day of death) with the most commonly used mode being video call (n = 30 day of death). CONCLUSION: This study is one of the first and largest Australian reports on how communication occurs at the end of life for patients dying of COVID-19. Contact rates were relatively low between patients and families, compared with other cohorts dying from non-COVID-19 related causes. The impact of this difference on bereavement outcomes requires surveillance and attention.
BACKGROUND: COVID-19 has led to challenges in providing effective and timely communication in healthcare. Services have been required to adapt and evolve as successful communication remains core to high-quality patient-centred care. AIM: To describe the communication between admitted patients, their families and clinicians (medical, nursing, allied health) during end-of-life care. METHODS: This retrospective review included all patients (n = 230) who died directly due to COVID-19 at five Melbourne hospitals between 1 January and 31 December 2020. Contacts and modality used (face to face, video, telephone) during the 8 days prior to death were recorded. RESULTS: Patients were predominantly elderly (median age 86 years) and from residential aged care facilities (62%; n = 141). Communication frequency increased the closer the patient was to death, where on day of death, contact between clinicians and patients was 93% (n = 213) clinicians and families 97% (n = 222) and between patients and families 50% (n = 115). Most contact between patients and families was facilitated by a clinician (91.3% (n = 105) day of death) with the most commonly used mode being video call (n = 30 day of death). CONCLUSION: This study is one of the first and largest Australian reports on how communication occurs at the end of life for patients dying of COVID-19. Contact rates were relatively low between patients and families, compared with other cohorts dying from non-COVID-19 related causes. The impact of this difference on bereavement outcomes requires surveillance and attention.