Abstracts

Rationale:
COVID-19 pandemic has impacted the delivery of routine health care in a significant way. It hampers patient care as well as affects the economic substance. Care of epilepsy patients is also affected by COVID. One of the most essential aspects of epilepsy management is admission into an Epilepsy monitoring unit (EMU). Due to the pandemic, the elective diagnostic tests put everybody involved at risk of contracting the virus. The social distancing restrictions forced the EMU admissions to be canceled or rescheduled to a later date. With the rise of telehealth within outpatient models, we wanted to introduce it within an EMU setting in the shape of virtual rounds. By doing so, we tried to minimize the person-to-person contact, which decreases the transmission of the virus.
Method:
We introduced the virtual EMU round at level 4 EMU at Duke children Hospital from June 1st, 2020. We divided our team into the inpatient staff and the virtually present staff. Inpatient staff consists of Pediatric neurology fellow, Pediatric residents, Epilepsy nurse Coordinator, and bedside nurses. The Virtually present staff consists of Epileptologist (supervising attending), Clinical neurophysiology fellow, pharmacist, and social worker. In the Pre-COVID era, all these personnel was present at the patient's bedside at the time of rounds. The process began with the creation of a secured institutionally approved virtual link with a password (created via the Zoom [TM]) to ensure the patient's privacy. We activated and circulated the link among the participants before entering the room. We used a computer on wheels with an active Audio/Visual connection for rounds. We discussed cases virtually and involved patient's families in decision making. Following the virtual rounds, we gave patients and relatives a survey to complete. The survey asked them to rate the quality of the A/V, the internet connection, and the effectiveness of the communication and the allotted time to discuss plans virtually. Direct feedback also had a section where parents could write their suggestions.
Results:
During the study period, we admitted six patients each week. Each family participated in a minimum of 2 virtual rounds during their stay and completed a single survey. 12 of 15 families were extremely satisfied with internet connectivity. 11 of 15 families were fully happy with audio/visual quality, and 13 of 15 families reported the communication was effective.
Conclusion:
Using this method, we ensure minimal contact risk of our medical personnel and maintaining the efficacy of the system. The majority of the families were satisfied with this experience. It has not compromised their expectations and patient care. Time to complete rounds is the same as before on average. The billing of these visits remains the same, provided that this is a free-to-use service. This setup is easy to replicate in any hospital situation with a secure internet connection and the ability to connect via audio/video software.
Funding:
:None