The widespread restrictions on the presence of loved ones and care partners in care settings across the continuum during the pandemic have resulted in serious unintended consequences for people at end-of-life, childbearing women, children and those with cognitive impairments. The Coalition developed a comprehensive set of Guidelines for minimizing unintended consequences of restrictive family presence policies during a pandemic.
Healthcare teams are working tirelessly to provide optimal care for patients, with the added stress of attempting to find a balance between maintaining safety by limiting exposure to the COVID-19 virus and supporting the emotional and psychological needs of their patients. It is time now to reassess family presence restrictions as we better understand how to contain spread of the virus, and availability of protective gear and testing capabilities expands.
Planetree International and ISQua support the essential engagement of patients and their families in decisions about their own care as a foundation of a high quality, person-centered healthcare system. We believe that it is imperative that we engage patients and families in the risk-benefit assessment and decisions around family presence, especially in the situations noted above. The safety and rights of all groups involved must be taken into consideration in an ethically sound manner. When one group makes determinations without including the patients and families who will be impacted most, it undermines person-centered care principles.
Safe family presence can be practiced with a well-planned approach during the COVID-19 outbreak. Establishing clear, safe and humane approaches now will help us as we face future challenges. To assist care facilities to establish effective and compassionate policies, an international, multi-stakeholder coalition including patient, family and elder advocates has developed a set of Guidelines for Preserving Family Presence (see inset). Use this link to access a full set of the visitation guidelines: bit.ly/familypresence
8 Guidelines to Preserve Family Presence in Pandemics and Other Challenging Times:
- Assess the need for restrictions to family presence based on current factual evidence. Continually reassess and adjust policies as conditions evolve.
- Minimize risk of physical presence by following appropriate infection control guidelines issued by the WHO and local and regional health authorities.
- Communicate what to expect proactively and with compassion so families do not appear at a facility unaware of restrictions that have been put into place.
- Establish and clearly state compassionate exceptions to family presence restrictions, for example in end-of-life situations.
- Support meaningful connections, using virtual or other means, to minimize isolation in cases where family is unable to be physically present..
- Inform and educate in cases where family can be with their loved one physically, adopting a shared decision-making approach to communicate the risks and benefits.
- Enlist family as partners for quality and safety, engaging them as members of the care team who share in the responsibility for abiding by established safety protocols.
- Enhance discharge education and post-discharge follow-up to support successful transitions of care, especially when family have not been present during a hospitalization.
About Planetree International
Started by a patient in 1978, Planetree International is a not-for-profit organization that partners with healthcare organizations across the globe to create cultures of person-centered care. The Planetree approach emphasizes the quality of human interactions and caring communication, the importance of connecting personnel to the deeper purpose of their work, and practical strategies for engaging patients, families and communities as true partners in care. As a person-centered care advocacy organization, Planetree International promotes respect, inclusion and compassion toward all who interact with healthcare systems. Our core philosophy of kindness, caring and respect seeks to help realize and sustain patient rights around the world. As part of this mission, Planetree has been developing and compiling resources to support organizations in maintaining person-centered care amidst the COVID-19 pandemic. These resources are available at https://www.planetree.org/pandemics-webinar
About the International Society for Quality in Health Care (ISQua)
The International Society for Quality in Health Care (ISQua) is a member-based, not-for-profit community that delivers a variety of initiatives and programmes. Our mission is to inspire and drive improvement in health, and the safety and quality of healthcare worldwide. When you join ISQua, you are investing in yourself, in addition to changing health care quality across the world. We foster a global community of passionate healthcare professionals, who are united by a single common goal: safer healthcare. Being a member gives you access to ISQua’s global community, exclusive website content, discounts to our conferences, access to the International Journal for Quality in Health Care, exclusive access to industry experts and much more. Find out more at https://www.isqua.org/membership.html. ISQua has created a resource page for COVID-19. We have collated resources from around the world to help provide the most up to date information to the healthcare community. Here you will find links to webinars, articles, research papers, recordings, podcasts, and other research portals. These resources are updated regularly. https://www.isqua.org/covid19-research-page.html Join ISQua to improve your Knowledge, build your Network, and make your Voice heard