Children’s Hospital at Dartmouth-Hitchcock (CHaD) is the only pediatric hospital in New Hampshire. It is located within the Dartmouth-Hitchcock Medical Center in Lebanon, NH.
In mid-March, based on data regarding the transmission rate of the virus, Dartmouth-Hitchcock made the decision to revise their visitation policy. Family members were no longer permitted in the hospital with the exception of the neonatal intensive care nursery (ICN), Birthing Pavilion, and for patients receiving end-of-life care.
The CHaD ICN Parent Council has been actively engaged in helping respond to the changes. Members provided input to ICN leadership who were advised by infectious disease specialists on letters providing the context for the family presence restrictions. The March 16th letter posted after the more restrictive policies were implemented was written in a clear and respectful manner, stating:
…These policy changes are intended to help protect babies in the ICN. Please help us follow these new restrictions until we are able to safely return to our standard policies.
We recognize the importance of your role as a healing partner for your baby here in the ICN. Your presence is important and we want you to be here with your baby.
Thank you for your understanding and patience during the challenging situation.
The ICN Medical Director met with families to explain the policy and reassure families. This practice served as a role model for other clinicians, staff, and trainees.
Council members provided input on how to continue multidisciplinary bedside rounds to ensure parents have the opportunity to participate fully. Currently just a few members of the care team round at the bedside instead of the full team. Other members participate via an iPad and communicate with families. Modifications will continue to be made with a full commitment to involving current families at the level they choose. The Council developed a letter to explain the reasoning behind the new rounding process and invite family participation. They also helped create a COVID-19 Breast milk information sheet.
Joanna Celenza, the March of Dimes/CHaD ICN Family Support Specialist and coordinator for the ICN Parent Council ensures that Council members and ICN staff are supported during this challenging time. She hosts an “Office Hours” webinar each day at noon for Council members to check in. This also allows for members to be kept updated so they are prepared to provide guidance for future requests. The Council also virtually stays connected using a project management and communication platform that allows them to work quickly and collaboratively. The ICN Leadership Team has relied on members of the Council to be the primary authors of family-facing communications, ensuring that these messages are supportive. This has helped clinical staff attend to other needs.
Every effort is being made to provide as much support as possible to families and to staff. A Wifi-enabled digital frame was set up for past ICN families to send in photos and messages of hope to staff and families with infants currently in the ICN. Photos and messages are sent via email or an app and the ICN Family Support Specialist serves as the monitor. For families who are quarantined at home, the ICN social worker has been trained to set up HIPAA-compliant video sessions to keep them connected to their baby and the ICN team. They are planning to provide online support sessions for families whose infants are currently in the ICN or who were in the past.