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Impact of Virtual Rounding for Patients with COVID-19 for Patient Satisfaction and Provider Safety

health care worker with tabletLed by Michael Usher, MD, PhD, assistant professor in the Department of Medicine, this study will examine if virtual rounding via a tablet can approximate the normal communication that occurs between practitioner and patient in a way that is satisfactory to both while reducing the risk of COVID-19 transmission and the need for personal protective equipment in times of substantial patient burden.

“Social distancing is a critical aspect of reducing the risk of disease transmission, but has not been optimally applied to hospital-based care. This is despite the fact that virtual visits will remain the backbone of our outpatient response to screening patients while minimizing risk of transmission,” said Usher. “While face-to-face encounters are a longstanding component of healthcare delivery, just as they may not be necessary outside of the hospital, they may be less important for stable patients with SARS-CoV-2 infection not needing critical care.”

While there is substantial active work on reducing transmission rates, screening, outpatient delivery, and management, Usher says innovations in inpatient delivery remain scant.

“This is problematic as the greatest volume of patients with severe disease will require a hospital bed, active management, but not critical care,” said Usher. “Since inpatient care requires frequent and prolonged in-person contact, the exposure risk for hospital-based providers and staff is high.”

According to Usher, exposure to healthcare practitioners creates a domino effect in two ways. First, it allows them to act as a vector for nosocomial transmission to other high-risk patients. Second, if practitioners become sick, this reduces the ability for hospitals to adequately staff for the surge. Usher and colleagues hypothesize that minimizing time spent in direct patient contact will likely reduce the risk of transmission.

By testing the feasibility of virtual rounding and impact on patient satisfaction and provider safety, validation of this approach can be rapidly adopted system wide, improving safety and efficiency without sacrificing quality, which in turn can create another tool for subsequent innovations.

Usher and team propose to rapidly employ a system of virtual rounding between COVID-19 patients and inpatient care teams using iPads stationed in patient rooms, nursing stations and with physicians to facilitate communication via FaceTime. The researchers will test the impact of virtual rounding on provider and patient satisfaction and safety using daily surveys to collect feedback on patient/provider communication and satisfaction to patients and the care teams as well as possible exposure rates and PPE use. These results will be compared with a convenience sample of COVID-19 patients without virtual rounding.

This project is supported by the UMN Campus Public Health Officer's CO:VID (Collaborative Outcomes: Visionary Innovation & Discovery) grants program, which support University of Minnesota faculty to catalyze and energize small-scale research projects designed to address and mitigate the COVID-19 virus and its associated risks.