A recently published literature review by Canadian researcher Cherniwchan (2021) explores virtual inpatient palliative care and associated barriers and implications of virtual services. Within inpatient palliative care, virtual services may include virtual visits with family and friends or virtual appointments with other members of a patient’s care team.
Cherniwchan explains that the appeal of virtual inpatient palliative services is that it allows for patients, families, and clinicians to connect while preserving supplies of personal protective equipment and mitigating risk of possible COVID-19 transmission. The author identified five themes across the 36 articles included in the review. The five themes were:
- The acceptability of virtual inpatient palliative care services during COVID-19
- Many patients and their family generally found inpatient virtual care accessible and were satisfied with the quality of care
- Logistical considerations of developing virtual services
- Establishment of virtual service best practices for health care workers
- Common technologies used
- Commercial video calling services
- Virtual healthcare platforms
- Strategies to support increase in number of patients
- Recruitment and organization of volunteers and staff
- Challenges associated with virtual inpatient services
- Patient privacy and quality of care
Although virtual services are a great option in situations such as pandemic, Cherniwchan indicated that there are specific circumstances where an in-person presence is preferred. For instance, in some cases, in-person visits may be required to provide a good-death experience for patients and family. A case study by Ann-Yi et al. (2021) further elaborates on the necessity of in-person visits at the very end of life during COVID-19. However, these authors note that it can be difficult to identify the correct time to allow family to visit patients given the inherent unpredictability of death. Ann-Yi et al. (2021) explains that the inability to facilitate an in-person visit and fulfil the wishes of patients and families is difficult for all individuals involved. As such, they also support accessible virtual family visits and advocate for clear regulations around visitation to mitigate family member confusion and frustration.
Even after the COVID-19 pandemic is behind us, virtual inpatient palliative care services may still be around. Circumstances such as physical distance or patient preference may require virtual rather than in-person visits. Having experience using these tools throughout the pandemic can allow organizations to continually offer virtual services to patients and families.
Citations:
Cherniwchan, H. R. (2021). Harnessing New and Existing Virtual Platforms to Meet the Demand for Increased Inpatient Palliative Care Services During the COVID-19 Pandemic: A 5 Key Themes Literature Review of the Characteristics and Barriers of These Evolving Technologies. American Journal of Hospice and Palliative Medicine®.
Ann-Yi, S., Azhar, A., & Bruera, E. (2021). Dying Alone during a Pandemic. Journal of Palliative Medicine.
