Improving communication between healthcare staff, patients, family members and close friends

To keep patients, NHS staff and the public safe, infection control measures and policies may sometimes mean that visiting patients is prohibited. During the first few months of the pandemic, all visiting was suspended, and this had a significant impact on patients, family members, friends, and staff. Patients were left feeling isolated and disconnected from their loved ones and family members and friends struggled to understand what was happening to the patient as well as being kept sufficiently informed.

Staff members currently use telephone calls to update family members. However, feedback from during the pandemic showed us that it was often very challenging for the information to be conveyed in this way and comprehension and retention of the information was poor. Furthermore, phone calls can be highly disruptive to care staff workflow and time consuming for family members.

In NHS Lothian we began using a basic app in 2020 that allowed us to share video clips and photos with family members. We used it for daily updates, to record key moments such as being extubated or physiotherapy sessions and also asked family members to send videos and photos from home to share with the patient. We received exceptional feedback from families who felt they had a much greater understanding of the patient’s condition and treatment, had a closer emotional connection, experienced reduced anxiety, and found it easier to disseminate information to wider family and friends.

Even when full visiting is allowed, it may still be a significant burden for family members and friends to make that journey. Between 2019-2020 over 35% of patients admitted to critical care in NHS Lothian lived over one hour travelling distance away, making it time consuming, expensive, and difficult to manage for families to visit alongside other life commitments. It may also be that significant events in a patient’s journey happen when a certain person cannot be present, such as speaking for the first time after being intubated or taking first steps after a major operation. We have been able to capture this in photo or video clips and share them with family and friends and for the patient to see during their recovery.

Predominantly in the NHS, written information is shared in paper format and either mailed or handed directly to a patient. This makes it easy to lose, difficult to share with others who are distant from the patient, not accessible to those with additional communication needs, and costly in terms of paper, ink, postage, and the environment. We wanted to allow information to be shared in a wide variety of forms to make it easier to access, understand, securely store, retain, and share.

Patient Connect is a new application that has been developed in conjunction with NHS Scotland and Microsoft.

The application currently provides the following features in critical care scenarios:

• Staff access through NHS Microsoft Teams account
• Secure portal for family members, friends, and patient via web browser
• Access to content controlled by staff, patient or next of kin. Restricted access for wider group of family members and friends
• Conversation feed for photos, videos, and written text
• Share documents such as Word, PDF, or PowerPoint
• Patient digital diary (GPICS national recommendation for all patients)
• Live video calls via Microsoft Teams
• Ward calendar to manage video call

NHS Lothian Pilot

In August 2022 we began the first ever pilot of Patient Connect with patients and family members in NHS Lothian. This was split between ICU in Western General Hospital and the Cardiothoracic Intensive Care Unit in the Royal Infirmary of Edinburgh. During this time, we asked NHS staff and members of the public to try the application and provide feedback on its features. Our emphasis was on whether the technology was intuitive, easy to use and accessible. We then held a focus group with members of the NHS Lothian ICU Steps Patient and Public Involvement group.

This was a fantastic opportunity to see how members of the public who had previously beenpatients in intensive care felt to see Patient Connect and discuss how it could be used. We touched on a wide variety of subjects including consent, patient diaries, how
the technology may be perceived in delirium and its use in the recovery period.