By Terri Mock - March 3, 2021
The COVID-19 pandemic has disrupted many areas of healthcare operations; and one of the areas that has seen some of the biggest changes is visitor management and communication. However, while technology has played a major role in keeping people in touch and facilitating safe visits, it has also excluded sections of the community from accessing critical information.
Prior to the COVID-19 pandemic, hospitals and healthcare facilities typically allowed inpatients to be visited by loved ones each day and outpatients to be accompanied to appointments by friends and family. Although there were limits on the number of visitors simultaneously allowed, these were generally in place for the comfort of other patients and to prevent overcrowding.
Then the pandemic started, and practically all hospital visits were stopped to mitigate the risk of healthcare workers and patients contracting the virus. As a consequence, mothers welcomed their babies into the world alone, inpatients underwent surgery without the support of family, and outpatients recently diagnosed with cancer had to attend chemotherapy sessions by themselves.
With hospital phone lines frequently being overwhelmed by concerned family and friends, some hospitals adopted video conferencing technology as a means of keeping patients in touch with loved ones and reducing the demand on hospital switchboards. Thereafter, as rates of infection declined, policies were relaxed so one visitor or companion would be allowed in certain circumstances.
The relaxation of hospital visitor policies brought a new set of issues. As most policies stipulated visitors, outpatients, and companions had to undergo a screening process of a health questionnaire and a temperature check before being allowed access, this could often result in bottlenecks at hospital receptions – creating difficulties with regards to maintaining social distancing policies.
To overcome this issue, several hospitals adopted contactless visitor management solutions – some using cutting edge technologies such as facial recognition and mask detection software, while others conducted temperature checks remotely. At the highest technological level, the solutions can be integrated with HL7-compatible EMRs to track outpatient movements around the facility.
The adoption of hi-tech visitor management solutions can also help with hospital security. For example, facial recognition software can be used to check visitors against databases of restricted individuals, wanted criminals, or sexual predators. The solutions can also be integrated with access control software to prevent visitors straying into restricted areas by accident - or on purpose.
However, due to the speed at which COVID-19 outbreaks occur, visitor policies and procedures can change at short notice. In these circumstances, communicating changes to policies and procedures has to be accomplished quickly in order to prevent scenarios in which visitors arrive at hospital receptions unprepared for a delay - or worse, told they will not be allowed to visit a family member.
Over the past twelve months, there have been numerous reports of security being called to pacify angry visitors at hospital receptions, and these scenarios have the potential to deteriorate into more serious incidents due to visitors – who may have been travelling for many hours and who are likely to be in an emotional state – becoming violent.
While many hospitals have promptly updated websites and notified local media when changes to visitor policies are implemented, individuals without access to the Internet are excluded from these communications. In some areas, large sections of the community do not have Internet access due to being uncomfortable with Internet technology or too poor to afford an Internet-enabled device.
However, although communities in cities such as Cleveland, Detroit, and St Louis, have low Internet adoption rates, 96% of the population owns a mobile device capable of sending and receiving SMS text messages. To address a lack of Internet connectivity hospitals can implement a mass text notification system with SMS opt-in and polling capabilities to communicate with non-digital visitors.
The system can be used in one of two ways to inform visitors about hospital visitor policies and procedures and changes to them as they occur. In both scenarios, hospitals ask visitors to opt in to the system by texting a keyword to a short code number. In the first example, keywords are assigned to specific areas of medical operations; while in the second example, a single keyword is used.
Because different policies and procedures can apply to different areas of medical operations (for example, one adult may be allowed to accompany another adult to the ER, but two parents are allowed to accompany a child to the ER), keywords are assigned to specific areas of medical operations. For example:
If a visitor wants to visit a patient in the Labor and Delivery Unit, they text “LABOR” to the short code number. This assigns them into a group who initially receive text messages with visitor policies specific to the Labor and Delivery Unit (see Scenario 2 for examples), and thereafter further text messages with updates until such time as the visitor texts “STOP” to the short code number.
The same principle can be applied for visitors that want to visit friends or family in the Psychiatric Unit (text “PSYCH”) or the Pediatrics Unit (text “CHILD”) or accompany an outpatient for a medical procedure (text “OUTMP”). Then, if visitor policies and procedures change for an individual group, a text message is sent to subscribers to that group. If the policies and procedures change for the whole hospital, every subscriber in every group is sent a text message with the revised policies.
In the second scenario, visitors opt in to the system by sending the same keyword to the hospital's short code number (i.e., text “POLICY” to 665544). Once opted in, they are sent a “poll” text asking which unit they want to visit. The text has multiple choice answers; and, depending on how the visitor responds, they receive follow-up texts explaining the policies and procedures for that unit:
Q: “Thank you for opting into the St. Raphael Hospital visitor communication system. Which unit are you interested in visiting?”
If the opted-in visitor now presses #1 on their mobile keypad, they receive automated follow-up text messages relevant to visitors to the Labor and Delivery Unit. For example:
Unlike in Scenario 1, opted-in visitors are not assigned to an individual group. This means if there are changes to the visitor policy for the Labor and Delivery Unit – but no changes in other units – it will be necessary to identify Labor and Delivery Unit visitors from initial poll text (i.e., those who responded #1). Therefore, the difference between the two scenarios is that the second is easier to set up, but it may create a minor administrative headache later.
The above scenarios of how a mass text notification system with SMS opt-in and polling capabilities are just two examples of how healthcare organizations can take advantage of technology to connect with nondigital communities. If you would like examples of other scenarios, or if you have a communication issue that might be addressed by mass text notifications, do not hesitate to get in touch.
Our team of safety experts will be happy to answer your questions and organize a demo of the Rave Alert mass text notification platform so you can see how the scenarios of SMS opt-in and poll texts work in practice. We will also be happy to tailor the demo to match any specific requirements you may have or to show the wider capabilities of Rave Alert for emergency preparedness, vaccine distribution coordination, and coronavirus recovery.
Terri Mock is Rave's Chief Strategy & Marketing Officer, overseeing strategy, product, and marketing. She is an executive leader with achievements in delivering revenue growth, driving go-to-market, innovating products, and scaling operations from high-tech startups to global companies.
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