Virtual Family Visits in Ontario's Hospitals: A Necessary Implementation
Due to the spread of COVID-19, only essential visitors – such as those visiting end-of-life patients or minors – are currently allowed in hospitals across Ontario (Mangione 2020). But what happens when a patient is dependent upon their family, and is not a minor? What can we learn from cases like those? The following insight into a recent judicial review involves a sick father, and his son who does not fall under the ‘essential visitor’ category (Ontario Superior Court of Justice 2020).
Edward Sprague is a 77-year-old man who suffers from an acute brain injury. He was admitted to North York General Hospital in March, 2020 (Trattner et al. 2020). His son, Andrew Sprague, is currently his substitute decision maker. Edward requires a gastronomy tube, and to prevent him from pulling it out, the clinical team has applied a variety of modifications including the use of soft restraints – all with the consent of his son. The restraints are released when either Andrew or a personal support worker is present.
Due to the spread of COVID-19, the hospital management at North York General Hospital have concluded that those who are not at risk of death cannot receive visitors, as this would put patients and staff at jeopardy. They determined that alternatives such as phone and video communication – which were already a part of the hospital’s routine practice – would be sufficient. Following the same, Andrew applied for a judicial review, citing a violation of Charter Rights and requesting unfettered access to in-person visitation with his father. Patients receiving visitors is an important part of their care under ordinary circumstances, as they help the patient feel a sense of comfort and decreased anxiety. However, upon thoroughly examining the arguments presented on both sides, the judge for this case deemed that the hospital visitation rules were reasonable under the current need for social distancing.
While all hospitals in Ontario are now affected by the visitation limitations set by this case, not all of them may be providing virtual visitations – highlighting the need to set a requirement for hospitals to create online access in the event that in-person visits are not allowed. This access needs to be at a level that simulates in-person visitations, where patients and relatives can interact with each other without the additional stress of massive amounts of coordination between themselves and hospital personnel. Patient and family-centered care is becoming an increasingly valued model to heighten a patient’s well-being. Visitors can boost morale, reduce patient anxiety in ICU settings, and provide detailed information about a patient to hospital staff (Trogen 2018). Given the benefits of family visitation, at a minimum we must try to over-compensate by providing online visitations that are seamlessly integrated into the patient’s day. Families must be involved in patient care – patients cannot do it alone.
Given this is a time-sensitive issue, we must start implementing enhanced virtual visits as soon as possible during the ongoing pandemic. However, as virtual care builds, we need to be mindful of the importance of providing equitable services to lower-income neighbourhoods and community hospitals.
About the Author(s)
Sneha Mukherjee is currently attending the Health Sciences program at McMaster University in Hamilton, and is passionate about health advocacy and raising awareness about health issues.
Mangione, K. 2020, March 23. Hospital, Care-Home Visits Now Restricted to Essential Stop-Ins Only in the Vancouver Area. CTV News Vancouver. Retrieved April 28, 2020. <https://bc.ctvnews.ca/hospital-care-home-visits-now-restricted-to-essential-stop-ins-only-in-the-vancouver-area-1.4865119>.
Ontario Superior Court of Justice. 2020. Citation: Sprague v. Her Majesty the Queen in right of Ontario, 2020 ONSC 2335. Retrieved April 29, 2020. <https://www.oha.com/Bulletins/Sprague%20v.%20HMQ(Ontario)%20corrected.pdf>.
Trattner, P., A. E. Reid and H. Kingdom. 2020, April 27. Recent Decision Provides Reassurance for Ontario Hospitals. Osler. Retrieved April 29, 2020. <https://www.osler.com/en/resources/critical-situations/2020/recent-decision-provides-reassurance-for-ontario-hospitals>.
Trogen, B. 2018, August 3. Do Hospital Visitors Impact Patient Outcomes? Clinical Correlations. Retrieved April 28, 2020. <https://www.clinicalcorrelations.org/2018/08/03/do-hospital-visitors-impact-patient-outcomes/>.
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