Joint Statement on Preserving Family Presence During Pandemics

The International Society for Quality in Healthcare (ISQua) and Planetree International participated in a ‘Pop-Up’ Coalition of over 60 organizations to Preserve Family Presence. The international group represented patient and long-term care advocates, quality and safety professionals, and global healthcare policy makers.

The widespread restrictions on the presence of loved ones and care partners in care settings across the continuum during the pandemic have resulted in serious unintended consequences for people at end-of-life, childbearing women, children and those with cognitive impairments. The Coalition developed a comprehensive set of Guidelines for minimizing unintended consequences of restrictive family presence policies during a pandemic.

Healthcare teams are working tirelessly to provide optimal care for patients, with the added stress of attempting to find a balance between maintaining safety by limiting exposure to the COVID-19 virus and supporting the emotional and psychological needs of their patients. It is time now to reassess family presence restrictions as we better understand how to contain spread of the virus, and availability of protective gear and testing capabilities expands.

Planetree International and ISQua support the essential engagement of patients and their families in decisions about their own care as a foundation of a high quality, person-centered healthcare system. We believe that it is imperative that we engage patients and families in the risk-benefit assessment and decisions around family presence, especially in the situations noted above. The safety and rights of all groups involved must be taken into consideration in an ethically sound manner. When one group makes determinations without including the patients and families who will be impacted most, it undermines person-centered care principles.

Safe family presence can be practiced with a well-planned approach during the COVID-19 outbreak. Establishing clear, safe and humane approaches now will help us as we face future challenges. To assist care facilities to establish effective and compassionate policies, an international, multi-stakeholder coalition including patient, family and elder advocates has developed a set of Guidelines for Preserving Family Presence (see inset). Use this link to access a full set of the visitation guidelines: bit.ly/familypresence

8 Guidelines to Preserve Family Presence in Pandemics and Other Challenging Times:

  • Assess the need for restrictions to family presence based on current factual evidence. Continually reassess and adjust policies as conditions evolve.
  • Minimize risk of physical presence by following appropriate infection control guidelines issued by the WHO and local and regional health authorities.
  • Communicate what to expect proactively and with compassion so families do not appear at a facility unaware of restrictions that have been put into place.
  • Establish and clearly state compassionate exceptions to family presence restrictions, for example in end-of-life situations.
  • Support meaningful connections, using virtual or other means, to minimize isolation in cases where family is unable to be physically present..
  • Inform and educate in cases where family can be with their loved one physically, adopting a shared decision-making approach to communicate the risks and benefits.
  • Enlist family as partners for quality and safety, engaging them as members of the care team who share in the responsibility for abiding by established safety protocols.
  • Enhance discharge education and post-discharge follow-up to support successful transitions of care, especially when family have not been present during a hospitalization.

About Planetree International

Started by a patient in 1978, Planetree International is a not-for-profit organization that partners with healthcare organizations across the globe to create cultures of person-centered care. The Planetree approach emphasizes the quality of human interactions and caring communication, the importance of connecting personnel to the deeper purpose of their work, and practical strategies for engaging patients, families and communities as true partners in care. As a person-centered care advocacy organization, Planetree International promotes respect, inclusion and compassion toward all who interact with healthcare systems. Our core philosophy of kindness, caring and respect seeks to help realize and sustain patient rights around the world. As part of this mission, Planetree has been developing and compiling resources to support organizations in maintaining person-centered care amidst the COVID-19 pandemic. These resources are available at https://www.planetree.org/pandemics-webinar

About the International Society for Quality in Health Care (ISQua)

The International Society for Quality in Health Care (ISQua) is a member-based, not-for-profit community that delivers a variety of initiatives and programmes. Our mission is to inspire and drive improvement in health, and the safety and quality of healthcare worldwide. When you join ISQua, you are investing in yourself, in addition to changing health care quality across the world. We foster a global community of passionate healthcare professionals, who are united by a single common goal: safer healthcare. Being a member gives you access to ISQua’s global community, exclusive website content, discounts to our conferences, access to the International Journal for Quality in Health Care, exclusive access to industry experts and much more. Find out more at https://www.isqua.org/membership.html. ISQua has created a resource page for COVID-19. We have collated resources from around the world to help provide the most up to date information to the healthcare community. Here you will find links to webinars, articles, research papers, recordings, podcasts, and other research portals. These resources are updated regularly. https://www.isqua.org/covid19-research-page.html Join ISQua to improve your Knowledge, build your Network, and make your Voice heard

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Nourhan Kawtharani

Nourhan, a quality and safety coordinator with eight years of experience in ambulatory healthcare in Lebanon, aims to deepen her understanding of the systemic and holistic approach to healthcare through this fellowship.

She aims to identify gaps and develop tailored interventions that address specific contexts rather than applying general solutions. Engaging with diverse professionals and perspectives during this educational journey will expand the application of these concepts across different cultural settings.

Nourhan emphasizes the importance of promoting a culture of continuous learning and improvement within healthcare institutions, considering it a vital leadership responsibility to integrate quality and safety initiatives into the organizational culture.

Nourhan's commitment to patient safety and quality management includes sourcing practical resources and transforming insights into actionable knowledge to drive continued progress in healthcare practices and outcomes.

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Elom Otchi

Elom is passionate about improving quality of care and patient safety outcomes.

In view of this, he has had the opportunity to work in various capacities with various organisations including AfIHQSA, WHO, UNICEF and others undertaking research, supporting the development of national quality policies and strategies, facilitating the establishment of quality governance systems across all the levels of the health sector and building capacity of national and sub-national quality leads/teams to institutionalize the practice of quality and patient safety across the continent.

He has also worked extensively across all levels of care in the health sector of Ghana, including leading the Quality & Patient Safety program in its largest teaching hospital.

I would like to use this Fellowship as a learning platform and an opportunity to acquire the requisite knowledge, skills and competencies to complement ongoing efforts by like-minded individuals and organizations to continuously advance improve the quality and patient safety in Ghana and the continent.

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Stephen Taiye Balogun

Stephen is a Senior Programme Officer at the Institute of Human Virology in Nigeria as well as Country Representative for Health Information for All (HIFA).

Stephen plans to use this opportunity to maximise his impact by championing the cause of patient safety and quality in Nigeria and across Africa.

Stephen says "Quality and safety is a major wheel through which universal healthcare coverage can be achieved. The goal is to be a bridge in the gap between the International Quality Improvement and Patient Safety community and my country to ensure rapid spread, adoption, implementation and practice."

We are looking forward to working with both Stephen and our 2020 winner Rhoda Kalondu over the next year.

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Dr Rhoda Kalondu

Rhoda is the Head of the Patient Safety Unit at Kenyatta Hospital in Nairobi and wants to use this Fellowship to learn how to establish a culture of safety and develop systems for assessment and analysis at her institution, and more widely. As well as this, Rhoda intends to develop and execute an intervention to improve patient safety in Kenyatta National Hospital.

It is one thing to institute measures and processes for improvement, but quite another to change the culture of an environment. Rhoda's ambition to lead others in this change inspired the panel.

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Dr Subhrojyoti Bhowmick

I am an MBBS graduate from Calcutta University with a Gold Medal in Gynecology & Obstetrics.

I have completed M.D in Pharmacology from IPGME& R, Kolkata and have over 12 years of experience in the field of Clinical Research, Pharmacovigilance and Medication management in Hospitals.

I have completed certification in Clinical Research Administration & Project Management from Stanford University, USA and in Patient Safety from Johns Hopkins University, USA.

I am an Assessor for National Accreditation Board for Hospitals & Health care providers (NABH), India assessing hospitals for medication safety and clinical quality standards and NABH Assessor for Ethics Committee Accreditation program in India as well.

I serve as the Chairperson, Institutional Ethics Committee of Health Point Hospital, Kolkata and am associated with 2 other Hospital ethics committees as a member.

I finished my Fellowship in Healthcare Quality from the International Society of Quality in Healthcare (ISQua) from Ireland in 2017.

I have published several research articles and have also authored a chapter on “Regulations governing Clinical Trial” in the book “Fundamentals of Clinical Trial & Research”.

I am a peer reviewer for prestigious international journals like the British Journal of Clinical Pharmacology, CNS Drugs and Drug Safety case reports.

I am the recipient of the UK Seth Oration Award for Best Clinical Pharmacology paper by the Indian Pharmacological Society in 2009 and the “Most promising Healthcare professional in Patient Safety in India” award by the Asian African Chamber of Commerce and Industry in October 2018.

Recently in April 2019, I received the Young Quality Achiever award by Consortium of Accredited Healthcare Organizations (CAHO), India for 2019 for my work in the field of medication safety and clinical research.

I have a keen interest in teaching and am visiting adjunct faculty of Pharmacology at KMC, Mangalore, India and for Healthcare technology at MAKAUT, Kolkata, India.

I was associated with Stanford University School of Medicine, in the USA as a Senior Clinical Research Associate from 2015 to 2017 and have certification in Biostatistics, Evidence-based Medicine and Medical Writing from Stanford University.

Currently, I am working as the Clinical Director of Academics, Medical Quality and Clinical Research at Peerless Hospital and B K Roy Research Centre, Kolkata.

I am very happy and thrilled to receive the prestigious ISQua Lucian Leape Patient safety Fellowship Award for 2019 and I look forward to honing my skills further in the field of healthcare quality and patient safety through my experiences during this fellowship.

I sincerely believe that successful completion of this fellowship will help me evolve as a more confident Patient safety leader in India who in turn can provide significant inputs on policy changes through NABH for the Indian healthcare system.

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