Hospital visitors in the time of COVID-19

Photo: Shawn Doyle (left) and Alex Van Luven, programmers and analysts at KHSC, stand next to the family presence registration application they developed using C Sharp and HTML5.

An application that registers all essential care partners during the pandemic has enabled Kingston Health Sciences Centre to maintain a safe, patient- and family-centred environment.

'Before COVID' is now a moment in time when people remember how things used to be, including how family members in hospitals could come and go freely, providing essential care and comfort to patients.

Now, during the pandemic, in order to prevent the spread of the virus, the number of care partners and visitors allowed in Kingston Health Sciences Centre's (KHSC) hospital sites is limited; but how do you keep track of these restrictions? There's an app for that.

"Even with family presence tightly restricted, it became clear very quickly that we were not going to be able to rely on paper and phone calls between the COVID screening stations at designated entrances and care settings to confirm permitted family members," says Elizabeth Bardon, KHSC's vice president of mission and strategy integration and support services.

She added that the inefficiency of the non-digital solution was frustrating for care partners and staff alike, at a time when their anxieties were already heightened because of the pandemic.

"Regular and ongoing consultation with our patient experience advisors helped us remain patient- and family-centred, and steered us toward finding a simplified way to allow essential care partners to enter and for the organization to document their presence," says Bardon.

KHSC's information and project management teams worked from mid-March to the beginning of April to build, test, and launch a web-based application that registers essential family members and pulls from the Patient Care System to link them to inpatients found in the system.

Most often, a designated family member is registered at the time a patient is admitted to hospital or upon arrival for an outpatient procedure or visit that requires family presence for safe care, as is the case for patients with dementia. On inpatient units, designated staff can also register family members following admission.

"It is important that the application is accessible within a wide-range of settings so that the priority remains documenting essential partners in care to our hospital sites, and the project team did an outstanding job of creating the safest and most seamless solution to do so," says Bardon.

In addition to quickly and easily being able to upload the name of an essential family member approved to visit a patient, the web application allows for the family presence to be temporary in situations such as on the day of a surgery only or ongoing for a patient who is actively dying. 

When family members arrive at designated entry points, they are screened for COVID and asked who they are coming to see. Once found in the web application, their ID is verified and presence – temporary or ongoing – confirmed.

The application, which records phone numbers, also makes it easier to do contract tracing if needed and to quickly remove privileges for family presence in the event of an outbreak or other health and safety situation.

KHSC was able to implement the application while many scheduled surgeries, procedures and visits were paused and only essential family members where allowed under exceptional circumstances. With time and not a lot of volume, KHSC was able to assess needs and improve the system.

Bardon says having a tried and enhanced application has been invaluable now that scheduled work has resumed and hospitalized patients are able to choose one family member to be their designated care partner and visit them on-site.

While hospital environments are not the same as they once were, the needs of family members to be with and care for the ones they love are unchanged. Another constant as the pandemic progresses is finding the right balance between offering a supportive patient- and family-centred experience and protecting the health and safety of all those who enter the hospital sites.