End-of-life care in the time of COVID-19: Communication matters more than ever.

Abstract Context The COVID-19 pandemic resulted in visitation restrictions across most healthcare settings, necessitating the use of remote communication to facilitate communication among families, patients and healthcare teams. Objective To examine the impact of remote communication on families’ evaluation of end-of-life care during the COVID-19 pandemic. Methods Retrospective, cross-sectional, mixed methods study using data from an after-death survey administered from March 17–June 30, 2020. The primary outcome was the next of kin’s global assessment of care during the Veteran’s last month of life. Results Data were obtained from the next-of-kin of 328 Veterans who died in an inpatient unit (i.e., acute care, intensive care, nursing home, hospice units) in one of 37 VA medical centers with the highest numbers of COVID-19 cases. The adjusted percentage of bereaved families reporting excellent overall end-of-life care was statistically significantly higher among those reporting Very Effective remote communication compared to those reporting that remote communication was Mostly, Somewhat, or Not at All Effective (69.5% vs. 35.7%). Similar differences were observed in evaluations of remote communication effectiveness with the healthcare team. Overall, 81.3% of family members who offered positive comments about communication with either the Veteran or the healthcare team reported excellent overall end-of-life care vs. 28.4% who made negative comments Conclusions Effective remote communication with the patient and the healthcare team was associated with significantly better ratings of the overall experience of end-of-life care by bereaved family members. Our findings offer timely insights into the importance of remote communication strategies.