Using GetWellNetwork in Hospice and Palliative Care
GetWell Inpatient promotional spaces provide each healthcare facility with promotional opportunities within a carousel navigation at the top of the patient's home screen. In 2019, GetWellNetwork developed a hospice and palliative care promotional space, with an initial launch at a Mid-Atlantic VA Medical Center. This particular space was built to address several unique needs of an inpatient hospice unit, and currently serves as a framework for other VA medical centers.
The ultimate goal of this promotional space was to supplement and complement the tireless hard work that is provided by the hospice and palliative care staff. In-room technology is never meant to replace existing in-person processes. Rather, it is meant to streamline workflow processes and also allow the family an additional way to digest necessary information at a very difficult and emotionally heavy time.
Why hospice and palliative care?
Hospice care is a specialized approach to end-of-life medical care that emphasizes quality of life, pain management, and symptom alleviation for terminally ill patients. It also addresses emotional and practical support for family and caregivers.
Palliative care is the treatment of mental and physical symptoms in patients suffering from a potentially life threatening illness. Not all of palliative care is hospice care, however all hospice care is palliative care. Palliative care can be helpful at any stage of illness and seeks to alleviate pain, shortness of breath, nausea, fatigue, constipation, and insomnia. It also supports the patient and the caregiver from an emotional, psychological, and religious standpoint.
Utilizing in-room technology, this hospice and palliative care promotional space was designed to standardize hospice and palliative care specific content, while also promoting patient experience through guidance, support, and assistance. Hospice and palliative care is often managed outside of an inpatient unit. However, with the GetWellNetwork technology installed in the emergency department, intensive care unit, med/surg unit, short-term rehab, CLCs and hospice, it was an opportunity to provide this cohesive content for any patient or family member in need.
At the time of creation, GetWellNetwork’s standard adult user experience was being used on all units throughout this VA Medical Center, and it focused on a safe and timely discharge for the acute inpatient population. Through education and patient engagement, it helped support other mitigation efforts to prevent negative patient outcomes such as avoidable readmission rates and extended adjusted length of stays. The available video content at the time was also aimed at this population. As mentioned previously, there are many similar themes in patient care — pain control, insomnia, shortness of breath, nausea, and constipation. However, the management of the dying patient is completely different and education gaps existed because of this.
Generally speaking, people who are dying need care in four areas:
- Physical comfort
- Mental and emotional needs
- Spiritual issues
- Practical tasks
Understandably, their family and caregivers need support as well. Further, according to the National Institute on Aging, families of people who received care through a hospice program are more satisfied with end-of-life care than those of people who did not have hospice services.
With the launch of the hospice and palliative care promotional space, GetWellNetwork was in a position to be able to support all of these efforts.
Making an impact in a time of need
The defined goals of this promotional space were to:
- Provide continuity of hospice and palliative care education across all units
- Address education gaps in hospice and palliative care education
- Promote a relaxing atmosphere
- Highlight facility- and unit-based initiatives such as aromatherapy, mindfulness, and The Honors Escort
- Make burial benefits visible and more digestible
Additionally, this promotional space was designed to meet the needs of a shifting demographic of the inpatient hospice Veteran, which includes a more diverse and blended family as well as younger children and spouses who were still in the workforce and visiting after hours. By having the most up-to-date education and benefits on a patient-facing TV, the family and caretakers are able to access the information at any time — including when the Veteran is resting, after hours, or when mentally ready.
Another goal of this space was for continuity of education across all units within the same VA. The specialization and breadth of these resources are not just limited to Veterans within the inpatient hospice unit. This allows the Veteran and their family to have access to the same end-of-life information, regardless of location.
Designed with the Veteran and their family in mind
From the discussions to launch, the building of this promotional space took about seven months. Collaboration took place between the inpatient hospice team and the palliative care team, which included participation from the director, nurse managers, physicians, social work, chaplain services, burial benefits, psychologists, and 24/7 inpatient nursing staff.
It was of paramount importance to both internal and external stakeholders that all four areas of need for the hospice and palliative care patient be addressed. The language used was also intended to educate and guide its viewer throughout the space, while also providing gentle reminders to reach out to staff with any questions or if overwhelmed.
Meditation, aromatherapy, and mindfulness initiatives were highlighted for physical comfort as they are known to positively impact blood pressure and pulse, pain, and anxiety.
Nature relaxation videos were highlighted, as some find music at low volume soothing and it may help with relaxation and lessen pain.
Additionally, at end of life, some may have spiritual needs that are as important as their physical concerns. Because of this, chaplain services and the awareness of a 24-hour on-call chaplain were highlighted for the Veteran and family. Live streaming of in-house services are also able to be connected here.
The final area of the tile space highlights grief resources, the VA’s National Caregiver Support Line, Goals of Care resources, additional web-based support, and burial benefits.
Burial benefits include:
- Veteran benefits
- Retired military Veterans
- Family member benefits
- How to plan a burial
- What to expect at a military funeral
- Burial at Arlington National Cemetery
- Burial at Sea program
- Veteran burial allowance
A large amount of effort and planning went into this area, as some of the most overwhelming aspects at end of life are the practical tasks that need to be addressed or completed, which are often a source of worry and stress for the dying patient and their family and caregivers. The right technology can help lighten that burden just a little.
Tracking outcomes and measuring success
From an operational standpoint, the projected outcomes for the new promotional space were to contribute to improvement in the following areas:
- Access to care
- Care coordination
- Employee engagement
- Technology and processes
- Clinical operations in nurse practice environments
- Standardization of care
- Communication with Veterans
Regarding this project, the inpatient hospice nurse manager wrote, “the partnership between [this VA] and GetWellNetwork helped expose all of us to the wonderful resources available […] I really believe that for some of our Veterans and their families, the inclusion of the New Rules for End of Life on the platform has been a real game-changer. This population also has some distinctive needs that were not consistently being addressed elsewhere — sleep, relaxation, meditation.
Truth is, it is not always easy to talk about or hear the types of things that need to be talked about at end-of-life. The GetWellNetwork Hospice and Palliative Care build doesn’t solve all of these problems, but does help empower the Veteran and their family to become a better advocate for themselves and their loved ones, while giving back a little of the control that disease has stripped away from them.”
This is one of the most rewarding aspects of GetWellNetwork’s work — to create and provide resources to meet the goals of the facility as they are providing direct patient care for their populations.