Virtual Care for Patients With Cancer in New Jersey During COVID-19
By Michele E. Gaguski, MSN, RN, AOCN®, NE-BC, APN-C
The COVID-19 coronavirus pandemic is unchartered territory with many unknowns, especially a new reality that nurses may be experiencing for the first time: virtual patient care. Even at a distance, the team at Jefferson Health New Jersey Sidney Kimmel Cancer Center in Sewell wanted to ensure we offered the same level of care and encouragement to patients in all phases of the cancer continuum, so here’s what we found worked for us.
Maintaining Interprofessional Communication
Our first step was implementing virtual Zoom meetings, which established a scheduled routine for discussing continued care. These meetings provided a standing forum for communication and feedback, which allowed for timely adjustments to workflows, early identification of concerns, assessment and re-assessment of personal protective equipment, staggered staffing models, and a venue for support and acknowledgements by team members.
To further foster camaraderie and support, our medical director hosts a weekly conference call with the entire staff, providing a space to share concerns, ideas, feedback, and inspirational affirmations.
Protecting Vulnerable Patients
We instituted a no-visitor policy with minor exceptions and a new check-in process for patients who needed in-person visits. When patients arrive in the parking lot for their services, they call their respective department and the staff calls them back when they’re ready to see the patient. This limits the number of patients in waiting rooms, thus adhering to safe social distancing practices. Throughout these changes, we’ve continued to offer free valet and transportation assistance to visitors.
The team also outlined a screening process at the building entrance to evaluate all visitors for COVID-19. Screenings included reading temperatures and providing masks to patients, staff, and others who need to enter the building (e.g., delivery personnel). Patients are also screened in our electronic medical record (EMR) system prior to any in-person visit. We added COVID-19 screening questions to our routine reminder calls and ask patients the questions again when they arrive. We’ve successfully maintained these screenings thanks to dedicated teamwork from various departments.
Connecting With Patients and Families
Telehealth gives us a crucial way to stay connected with our patients. Our center was an early adopter of telehealth technology, so we swiftly converted any clinic visits that didn’t need to be in person to online. Our challenge was to notify patients and walk them through setting up telehealth. If they were unable to use telehealth because of technology constraints, we coordinated an over-the-phone visit.
Oncology supportive programs, like social work, support groups, and nutrition, also transitioned to telehealth, and our team has been using social media and email to educate patients about safety, telehealth, and coping and stress management.
Patients starting chemotherapy treatments now provide electronic consent, and nurses lead virtual chemotherapy education appointments for patients and their caregivers, allowing for one-on-one teaching and a virtual tour of the infusion suite prior to their first visit.
As evidence on the pandemic evolves, we still have a lot to learn, but through intensive teamwork we’ve adapted new models of ambulatory cancer care and ensured the safety and well-being of both patients and staff during COVID-19.
Acknowledgements: The author would like to recognize all the team members at Jefferson Health New Jersey Sidney Kimmel Cancer Center in Sewell for their exemplary dedication to our patients and each other throughout the pandemic.