Creating a Dedicated Palliative Care Team for ICU Spanish Speaking Patients in Response to COVID-19.

CONTEXT: The Latinx population faced higher rates of infection and severe illness during the COVID-19 pandemic, resulting in an increased need for palliative care services. OBJECTIVES: We describe the creation and impact of a formal palliative care initiative developed for seriously ill, Spanish-speaking patients during the COVID-19 pandemic at a tertiary care academic medical center. METHODS: Patients were enrolled in the Spanish Palliative Care Initiative during a two-month period starting in April 2020. Selected patients were longitudinally followed by a rotating team of Spanish-speaking palliative care clinicians. Following the intervention, a retrospective chart review was conducted to evaluate the impact of the program. RESULTS: We enrolled 22 patients. The most frequent palliative care task completed during the initial visit was information giving (77%) and during follow-up visits were goals of care discussion (59%) and coping support (59%). Fifteen patients (68%) had a change in code status and 4 patients (18%) were discharged to hospice. CONCLUSION: The creation of a focused clinical program targeting a historically marginalized population offered opportunity for early palliative care intervention in clinical care for Spanish-speaking patients. This underscores the need for Spanish-language concordant palliative care to improve serious illness care, and end-of-life care, by providing continuity of care, spiritual care, and ICU team support.

All Virtual All the Time? Let's Make TelePalliative Care Work for All of Us (FR255)

Outcomes 1. Describe current approaches to palliative care telemedicine 2. Analyze the outcomes of widespread telemedicine use in palliative care 3. Design sustainable integration of telemedicine into palliative care programming Before the COVID-19 pandemic, telemedicine was not heavily used in palliative care;clinicians were not comfortable with it, and there was a paucity of research on its use. Though the pandemic summoned telemedicine to the frontlines, there was little guidance on how it could be used effectively. In this session, we will share our experience providing palliative telemedicine in four different practices during the pandemic. We identified advantages to telepalliative care such as access, patient preference, schedule flexibility, lower no-show rates, and seeing patients in their home environment with the potential for family members to easily join visits. We also identified challenges such as limitations in technology and physical examination, changes in patient volume, and perceptions of personal connection during in-person visits between providers and patients. As we emerge from the pandemic toward a new normal, many palliative care programs will continue to use telemedicine in their practices. In doing so, they will have to determine how to appropriately allocate a provider's time, identify ideal telemedicine patients, and decide on the setting of the service. Palliative care programs will also have to navigate potential changes in legal regulations and insurance reimbursement. With these factors in mind, we will share recommendations on continued integration of palliative telemedicine. Telemedicine is integral to the future of palliative medicine, so let's make it work for all of us.

Cancer Patient Management during COVID-19 Pandemic: An Audit of a Single-Surgeon Unit in a COVID-Hotspot.

The report evaluates the effect of coronavirus disease (COVID-19) pandemic on breast cancer treatment and management at a single-surgeon cancer care unit in one of the hotspots of COVID-19 in India. In response to the pandemic, the adjustments were made in the clinical practice to accommodate social distancing. Patient consultations were done over phone call or in-clinic visit with prior appointment to reduce the risk of exposure to COVID-19. Total number of patients that were treated at the clinic and the essential surgeries performed during the pandemic phases are summarized in the report. The methodology adopted here for care and management of the cancer patients can serve as a guiding principle for cancer care units in the country.