Hospices nationwide are designating specific interdisciplinary clinicians who work exclusively with COVID-positive patients to reduce risk to the rest of their staff and vulnerable patient populations. Selecting staff to serve on dedicated COVID teams has involved several considerations and additional measures as hospices work to minimize exposure.
“The communities we serve in general are seeing more and more patients that test positive [for COVID-19],” said Mandy Cogswell, chief clinical officer, Minnesota-headquartered St. Croix Hospice. “Given that we go into these communities and populations who are so vulnerable, it’s been our biggest priority to make sure that our staff and our patients are safe. Our own patient populations have not seen a major influx of COVID-positive patients, but the numbers are on the rise. Separating those team members that see COVID patients from those who do not allows us to have non-COVID team members who can care for other hospice patients without bringing any known exposure to COVID-19 and be even more careful to not spread the infection.”
In many cases, COVID-dedicated teams have consisted of primarily staff who volunteered to serve patients testing positive including nurses, nursing aides, physicians and even clinical leadership. Developing criteria for COVID team members was an early challenge for hospice providers as these teams began to take shape.
“What we would look for is really that which all hospice nurses typically have,” Cogswell said. “There’s going to be more shortness of breath and respiratory issues. Hospice clinicians already have a really good foundation of skills when it comes to managing those types of symptoms. It’s just applying more of those skills and making sure staff are really strong in their infection control protocols. This is why we’ve provided the extensive COVID-related training across the board, not just to the dedicated team.”
Staff across hospice organizations nationwide have received additional training in compliance with federal, state and local safety protocols intended to minimize the pandemic’s spread. Dedicated COVID teams are especially trained in understanding the disease’s spread and impact, along with effective screening and infection prevention methods, as they put their own health and families at risk serving infected patients.
Dedicated COVID teams need to have the ability to address more than just the medical needs of patients. COVID teams also receive training in connecting patients and families to complementary therapies and supportive services so crucial to hospice care. With accessibility to patients limited amid social distancing measures to slow the pandemic’s spread, training in providing telehealth utilization has been increasingly important to continue providing spiritual and grief support, social services and counseling.
“Limited social interaction was taking a big toll on our patients and their families who were upset that they couldn’t see their loved ones,” said Kevin Stock, vice president of Moments Hospice serving locations in Minnesota, Wisconsin and Iowa. “Our COVID-19 team visits are on average two to three hours long per patient, providing hospice care and social interaction and utilizing our telehealth system to check in with their family and friends while our staff was with our patients. Our chaplains and social workers are doing about 50% of their visits in person versus telehealth, and our music therapists are 100% telehealth.”
With the dramatic shifts in care delivery occurring during the pandemic, these teams could serve as a model for operations in future emergencies. From revised patient visit procedures to reevaluated staffing policies, hospices continue to evolve from the pandemic’s challenges.
“Staff having been tested physically, emotionally and mentally. This can also build an extra confidence,” said Oscar Limas, director of program operations at AAdi Home Health & Hospice in Corpus Christi, Texas. “The COVID team feels strongly that they had an extra drive to push through this and get people taken care of with extra precautions and care needed by those patients and families. Knowing that we have employees that are definitely dedicated to stepping up in these types of emergency situations is going to go a long way. A lot of the precautions we’re taking now for COVID are some that are probably going to stay in our processes and carry on through even the time when this pandemic is no longer an issue.”