| Themes |
Lessons learned/Issues identified by HCWs |
| Mobile phone communication policy |
Clear process and responsibility of saving next of kin number. Fixed time for attending calls, sequence of calls to family to be fixed. For example, start with doctor’s counseling, followed by billing and finance related. Need to ask permission before disclosing patient information to unsaved numbers. Use audio calls for routine information, and restrict video calls for counseling. Clear protocol for bringing in translators, and social workers on counseling calls. Clear protocol on recording consents on phone and saving procedure. Clear protocol for ensuring the privacy of patient and patient information. Delete phone numbers on death or discharge. |
| Communication and counseling training for intensivists and ICU nurses |
Communication with patience giving details of uncertainty and rapid deterioration possibilities towards building trust. Truth-telling with balance of reassurance. Learn how to address “silly" and waste of time questions". Being courteous even when stressed and handling emotional stress of death. Importance of clear, simple, empathic language. Handling transference and countertransference. Use ongoing situations, such as global news to help convey patient's condition. Anticipate requirements of consent and prepare the family. Shadow seniors during counseling. Seek feedback and guidance. |
| Protocols for high restriction, intensive care units in pandemic situations |
Pre-ICU admission communication process needs to be rigorous. Detailed handover communication processes at shift change, especially because of leave periods. Intra-team communication processes to avoid mix-ups. Visitation protocols for family members, support groups, and religious persons with testing, fitness, and PPE compliance. Stick to only one to two close relatives for counseling. Repeated counseling in case of deterioration in patient condition. Increased number of personnel, specifically to handle phones, financial matters, counseling support, government-police liaison. Opportunities for inter-team anxiety management, such as bonding/destressing activities. Celebrate and reward-special efforts and immense cooperation between consultants, residents, nurses, and technicians. |
