ICU Volunteer "Transition Guides": A Prospective Study on Improving the Patient Transfer Experience.

BACKGROUND: This study was conducted to measure the impact of a volunteer "Transition Guide" on patient experience and psychological stress during the transition from ICUs to general medical and surgical wards. METHODS: Between July 2017 and February 2020, medical and surgical patients from nine ICUs at a single tertiary care hospital were accompanied by a uniquely trained volunteer Transition Guide to aid them at the time of transfer to general medical/surgical wards, when available. If a Transition Guide was not available, they were transferred without one. The following day, patients were surveyed with a tool assessing overall satisfaction, multiple aspects in the domain of communication, and psychological stress associated with the transition process. When available, family members and ward nurses who admitted patients from the ICU were surveyed. RESULTS: Target enrollment was 300 patients in each group. Due to COVID-19 and institutional restrictions on volunteers, only 264 underwent transfer with a Guide, while 305 transferred without one. Of all patients approached, 95% with a Guide and 96% without a Guide completed the survey. Patients who were accompanied by a Transition Guide reported a better overall transition, better communication, greater understanding, better resolution of concerns, and less stress than those who did not have a Transition Guide (p < 0.05 for all). CONCLUSION: Among a cohort of formerly critically ill patients subsequently transferred to general medical and surgical wards, the presence of a volunteer Transition Guide significantly improved patient experience, enhanced patient communication and understanding, and reduced stress associated with the transfer process. Hospitals may consider this expanded and specialized role for volunteerism in the health care setting to improve patient-centered outcomes.

The COVID-19 Impact on Childcare in Agricultural Populations.

The corona virus pandemic pulled back the curtain on rural America's already fragile childcare system and shed light on the critical role that quality, affordable, accessible childcare plays in the lives of workers and families, as well as in the success of agricultural businesses. This commentary aims to describe how existing childcare problems were exacerbated by the COVID-19 pandemic, potentially impacting both the health and economics of farm households and farmworker families. For solutions to be successful, efforts will need to be collaborative, with federal interventions spurred on by childcare stakeholders. Successful collaborations will result in a better childcare system that nurtures children while their parents contribute to our nation's production of agricultural products.