Mass Production of Compassionate Communication in the Era of COVID-19

Summary

In March 2020, Parkland Hospital opened its COVID ICU (“ICU”) for patients who required mechanical ventilation. Despite high risk of mortality, patients were separated from their families due to necessary, but prohibitive, visitation policies. The ICU and palliative care teams (the latter, staffed primarily by UT Southwestern Medical Center physicians) created a novel care model, which facilitated daily communication with families of over 500 patients in the ICU (from March 2020-2021). The team assembled a network of physician volunteers to “adopt” ICU families and generated scripts to facilitate formation of a therapeutic alliance, counseling regarding prognosis and COVID-specific complications, exploration of values, delivery of recommendations regarding treatment options, and provision of emotional support. Members of the palliative care team rounded with the ICU team, assisted with symptom management, and coached volunteers. These strategies allowed the team to double the typical daily census of the palliative care team with no increase in staffing resources.