Remote Advance Care Planning in the Emergency Department During COVID-19 Disaster: Program Development and Initial...

Area of Science:

• Healthcare Management
• Patient Communication
• Emergency Medicine

Background:

• The COVID-19 pandemic strained emergency departments, necessitating innovative patient care strategies.
• Hospitals required adaptive solutions for safe and effective patient management during the crisis.

Purpose of the Study:

• To disseminate a novel program for advance care planning communications developed during disaster conditions.
• To address the need for effective goals of care discussions in a high-pressure environment.

Main Methods:

• Program development and initial evaluation of the Remote Goals of Care program.
• Facilitating remote communication between families and patients regarding care preferences.
• Utilizing remote nurses to conduct goals of care conversations.

Main Results:

• Conducted 64 remote goals of care conversations, with 72% involving families of incapacitated patients.
• Discussions covered patient preferences, code status, diagnosis understanding, prognosis, and hospice care.
• Identified needs for rapid response, interspecialty collaboration, and improved technology and documentation.

Conclusions:

• The Remote Goals of Care Program effectively reduced emergency department burden for goals of care discussions.
• The program was well-received and shows promise for replication in other healthcare facilities.
• Future iterations can enhance accessibility through additional services and technological adjustments.