Novel Communication Liaison Program in the COVID-19 Intensive Care Unit: Impact on Liaison Participants (W225D)

• Published in: Journal of pain and symptom management Vol. 61; no. 3; pp. 644 - 645
• Main Authors: Moraco, Nicole H., Lipworth, Adam D., Harper, Megan E., Keitz, Sheri A., Mosenthal, Anne C.
• Format: Journal Article
• Language: English
• Published: Madison Elsevier Inc 01.03.2021; Elsevier Limited; Published by Elsevier Inc
• Subjects: Coaching; Communication skills; Coronaviruses; COVID-19; Critical care; End of life decisions; Family relations; Hospice care; Hospitalized; Intensive care; Interviews; Liaison; Palliative care; Pandemics; Patients; Polls & surveys; Psychological distress; Response rates; Sense of purpose; Teams; Verbal communication
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2021.01.021

Objectives 1. Explain the process for creating and implementing a Communication Liaison (CL) program. 2. Discuss the Impact of the Communication Liaison program on liaison participants. Original Research Background During the COVID pandemic, families were barred from their hospitalized loved ones, while surge critical care teams were overwhelmed with hundreds of patients, leaving little capacity for remote communication. We implemented a novel Communication Liaison (CL) program, following the palliative care consultative model, to facilitate communication between critical care teams and families, and to provide emotional and decisional support to families. Research Objectives The CL program aim was to rapidly train and deploy novice providers in communication support for families. This study evaluated the experience and impact on liaisons during the surge. Methods We developed "just-in-time" training in key elements of critical care and palliative medicine. To support liaisons through difficult conversations and challenging family interactions, we deployed liaisons in teams with tailored reference material, peer coaches, and palliative care subspecialists. Post-program survey and semi-structured interviews were conducted to evaluate the impact on liaisons. Results Liaison survey response rate was 90% (56/62). As compared to baseline, CLs agreed/strongly agreed that their ability to discuss end-of-life care decisions and handle emotional conversations with families increased from 50% to 93%, and 73% to 98%, respectively. Additionally, 100% of liaisons agreed/strongly agreed that the program provided an invaluable service to families. Themes elicited during the post-program interviews revealed an enhanced sense of purpose and a renewed connection to patient care that will change their future practice. Conclusion and Implications for Research, Policy, or Practice Rapid training and coaching of novice CL during COVID-19 surge was feasible and effective and is an easily scalable model of primary palliative care for subsequent surges. Despite potential for distress, liaisons reported that the experience was meaningful and increased their confidence in communication skills and difficult conversations.