Background: Transparency is espoused as a valued attribute of healthcare communication, yet best practices for communication about critical care resource allocation in the context of global pandemics, are not well established. During the COVID-19 pandemic, communication about triage and resource allocation emerged as a priority issue. This study explored the perceptions of health care providers regarding the challenges of, and their preferences for, transparency in communicating critical care triage criteria and subsequent care plans for seriously ill patients with COVID-19 who would not be prioritized for critical care. Methods: We used a rapid qualitative descriptive study design implemented over 3.5 weeks in April 2020 during the first wave of the pandemic. Following ethics approval we used purposive criterion and snowball sampling to recruit individuals who were or positioned to be involved in communicating triage allocation for patients with life-threatening COVID-19-related illness. Participants chose individual semi-structured telephone interviews or a web-based survey. Directed content analysis was employed to extract transcribed interview and survey data to a priori codes. Coordinated, rigorous and iterative analysis was undertaken by team members to achieve results consensus. Findings: Fifty-two interviews and 15 surveys were completed, representing all WHO regions and high, middle- and low- income countries. Transparent communication was an ideal practice. However, transparency about triage criteria and available care was understood to be ‘relative’ in nature, influenced by socio-political context and concerns about inciting fear, social disruption and heightening suffering. In some situations, participants focused on what patients and families could do (handwashing, prayer, comfort care), instead of critical care they could not have. The moral weight of transparent communication was highlighted. Discussion: Specific, contextually-derived strategies are needed to thoughtfully communicate challenging information at individual and population levels during pandemic crises. Findings can guide development, training and support for these strategies.
Strachan, P., Luciani, M., Schwartz, L., Kapiriri, L., de Laat, S., Conti, A., et al. (2020). Transparency in the time of COVID-19. Intervento presentato a: International Conference on Communication in Healthcare ICCH 2020, Virtual.
Transparency in the time of COVID-19
Luciani M.Secondo
;
2020
Abstract
Background: Transparency is espoused as a valued attribute of healthcare communication, yet best practices for communication about critical care resource allocation in the context of global pandemics, are not well established. During the COVID-19 pandemic, communication about triage and resource allocation emerged as a priority issue. This study explored the perceptions of health care providers regarding the challenges of, and their preferences for, transparency in communicating critical care triage criteria and subsequent care plans for seriously ill patients with COVID-19 who would not be prioritized for critical care. Methods: We used a rapid qualitative descriptive study design implemented over 3.5 weeks in April 2020 during the first wave of the pandemic. Following ethics approval we used purposive criterion and snowball sampling to recruit individuals who were or positioned to be involved in communicating triage allocation for patients with life-threatening COVID-19-related illness. Participants chose individual semi-structured telephone interviews or a web-based survey. Directed content analysis was employed to extract transcribed interview and survey data to a priori codes. Coordinated, rigorous and iterative analysis was undertaken by team members to achieve results consensus. Findings: Fifty-two interviews and 15 surveys were completed, representing all WHO regions and high, middle- and low- income countries. Transparent communication was an ideal practice. However, transparency about triage criteria and available care was understood to be ‘relative’ in nature, influenced by socio-political context and concerns about inciting fear, social disruption and heightening suffering. In some situations, participants focused on what patients and families could do (handwashing, prayer, comfort care), instead of critical care they could not have. The moral weight of transparent communication was highlighted. Discussion: Specific, contextually-derived strategies are needed to thoughtfully communicate challenging information at individual and population levels during pandemic crises. Findings can guide development, training and support for these strategies.
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