Perspectives on Telephone and Video Communication in the ICU during COVID-19.

Rationale During the COVID-19 pandemic, many intensive care units have shifted communication with patients' families toward chiefly telehealth methods (phone and video) to reduce COVID-19 transmission. Family and clinician perspectives about phone and video communication in the ICU during the COVID-19 pandemic are not yet well-understood. Increased knowledge about clinicians' and families' experiences with telehealth may help to improve the quality of remote interactions with families during periods of hospital visitor restrictions during COVID-19. Objective To explore experiences, perspectives and attitudes of family members and ICU clinicians about phone and video interactions during COVID-19 hospital visitor restrictions. Methods We conducted a qualitative interviewing study with an intentional sample of twenty-one family members and fourteen treating clinicians of cardiothoracic and neurologic ICU patients at an academic medical center in April 2020. Semi-structured qualitative interviews were conducted with each participant. We used content analysis to develop a codebook and analyze interview transcripts. We specifically explored themes of effectiveness, benefits and limitations, communication strategies, and discordant perspectives between families and clinicians related to remote discussions. Results Respondents viewed phone and video communication as somewhat effective but inferior to in-person communication. Both clinicians and families thought phone calls were useful for information-sharing and brief updates, while video calls were preferable for aligning clinician and family perspectives. Clinicians and families expressed discordant views on multiple topics-for example, clinicians worried they were unsuccessful in conveying empathy remotely, while families felt empathy was conveyed successfully via phone and video. Communication strategies suggested by families and clinicians for remote interactions include identifying a family point-person to receive updates, frequently checking family understanding, positioning the camera on video calls to help family see the patient and their clinical setting, and offering time for the family and patient to interact without clinicians participating. Conclusions Telehealth communication between families and clinicians of ICU patients appears a somewhat effective alternative when in-person communication is not possible. Use of communication strategies specific to phone and video can improve clinician and family experiences with telehealth.