BMJ Supportive & Palliative Care · 2020 · 17 citations · 0 references
NursingHealth Care ManagementHealth Services AdministrationMedical EthicsPalliative CarePalliative MedicineEnd-of-life Care PlanningEthical Issues In End-of-life CareIntegrated Palliative CarePalliative Care EthicsTerminal CareCare Coordination In Virtual VisitsCommunication Barriers In Virtual VisitsLogisticsPalliative Care Delivery ModelsPalliative Care ManagementVirtual Care DeliveryVirtual Visit Workflow DesignVisit Preparation
While the additional value from adding the option of virtual visits is not in question, numerous issues are raised around how to decide between face-to-face and virtual visits in individual cases and how best to set up such provision within an organisation. With only limited palliative care-specific literature and no time to set up and evaluate pilots, we had to get on and set up a prototype 'virtual visits' model, retro-fitting guidance and a supporting ethical framework. We looked at the issues spanning clinical, ethical and logistics domains; identifying areas of benefit as well as drawbacks, some specific to the rushed implementation because of COVID-19's infective risks and the 'rules' of lockdown, but many are generic areas to help guide longer term service design. Unsurprisingly, it appears clear that a 'one-size-fits-all' mentality is a poor fit for the individualised needs of the heterogeneous palliative care population. Virtual visits have great potential even if they are not a panacea.