Quality of Telehealth-Delivered Inpatient Palliative Care During the Early COVID-19 Pandemic

Ann A. Soliman, Kathleen M. Akgün, Jane Coffee, Jennifer Kapo, Laura J. Morrison, Elizabeth Hopkinson, Dena Schulman-Green, Shelli L. Feder

Research output: Contribution to journalArticlepeer-review

Abstract

Context: Consequent to increasing COVID-19 infection rates, the Palliative Care (PC) service at a large New England hospital shifted from in-person to telehealth-delivered PC (TPC). Objectives: We compared the quality of TPC to in-person PC during the early COVID-19 pandemic. Methods: We conducted an electronic health record review of PC consultations of patients hospitalized during three periods: pre-COVID January, 2020-February, 2020 (in-person); peak-COVID March, 2020-June, 2020 (majority TPC); and post-peak September, 2020-October, 2020 (majority in-person). We examined the relationship between these periods and PC delivery characteristics and quality measures using descriptive and bivariate statistics. Results: Of 377 patients, 50 were pre-COVID (TPC=0%), 271 peak-COVID (TPC=79.3%), and 56 post-peak (TPC<2%) (representation of PC consult: pre- and post-peak=samples; peak-COVID=all consults). Mean age was 69.3 years (standard deviation=15.5), with 54.9% male, 68.7% White, and 22.8% Black. Age and sex did not differ by period. PC consultations were more likely for goals of care (pre=30.0% vs. peak=53.9% vs. post=57.1%; P = 0.005) or hospice (4.0% vs. 14.4% vs. 5.4%, P = 0.031) during peak-COVID compared to pre-COVID. Rates of assessment of physical (98.0% vs. 63.5% vs. 94.6%, P < 0.001) and psychological symptoms (90.0% vs. 33.1% vs. 67.9%, P < 0.001) were lower during peak relative to pre-COVID and post-peak periods. There were no differences in assessment of patients’ social needs, family burden, or goals of care across periods. Conclusion: The PC service provided high-quality inpatient PC using TPC despite significant strain during the early COVID-19 pandemic. Developing and testing strategies to promote comprehensive symptom control using TPC remains a priority to adjust to potential unmet PC needs.

Original languageEnglish (US)
Pages (from-to)6-15
Number of pages10
JournalJournal of Pain and Symptom Management
Volume65
Issue number1
DOIs
StatePublished - Jan 2023

Keywords

  • COVID-19
  • Palliative care
  • end-of-life care
  • goals of care
  • hospice
  • telehealth

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Fingerprint

Dive into the research topics of 'Quality of Telehealth-Delivered Inpatient Palliative Care During the Early COVID-19 Pandemic'. Together they form a unique fingerprint.

Cite this