E-070 The use of inpatient virtual shared medical appointments for patients with acute cerebrovascular pathologies and their caregivers: a pilot study to improve health literacy, patient self-efficacy and reduce provider burnout. (23rd July 2022)

• Record Type: Journal Article
• Authors: Mahajan, U; Sharma, N; Maynard, M; Kang, L; Labak, C; Sajatovic, M; Hoffer, A; Shammassian, B; Wright, J; Zhou, X; Wright, C
• Is Part Of: Journal of neurointerventional surgery. Volume 14(2022)Supplement 1
• Page Start: A112
• Page End: A113
• Publication Date: 2022-07-23
• Subjects: Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2022-SNIS.181
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Objective: Admission to the hospital for an acute cerebrovascular condition such as stroke or brain hemorrhage can be a traumatic and disorienting experience for patients and their family members. The COVID-19 pandemic has further intensified this experience in addition to exacerbating clinician and resident burnout. To ameliorate some of these concerns, a team of resident and medical student trainees implemented a virtual shared medical appointment (vSMA) program for inpatients with acute cerebrovascular disorders and their caregivers. This study hypothesized that an early intervention vSMA improves patient and caregiver health literacy and preparedness, simultaneously educates trainees on effective communication skills, and reduces clinician burnout. Methods: Patients and caregivers of admitted patients were screened through the neurosurgery, neurocritical care, and neurology electronic medical record census. A weekly 60-minute secure virtual session consisted of introductions, a 10-minute standardized presentation on cerebrovascular disease management, followed by participant-guided discussion. Participants completed pre- and post-surveys. We report data on this feasibility study and present challenges, both expected and unforeseen. Results: A total of 170 patients were screened; 13 patients and 26 caregivers participated in at least 1 session. A total of 6 different healthcare providers facilitated sessions. The vSMA program received overwhelmingly positive feedback from caregivers. Surveys demonstrated 96.4% of caregivers and 75% of patients were satisfied with the session. 96.4% of caregivers and 87.5% of patients would recommend this type of appointment to a friend or family member. 88.8% of providers felt validated by conducting the session. The participant group had a 20% greater percentage of patients discharged home without home needs compared to the non-participant group. The primary obstacle encountered included technological frustrations with the consent process and the sessions themselves. Conclusions: Implementation of a vSMA program at a tertiary care center during a pandemic was feasible. Themes caregivers expressed on the post-survey included better understanding of caring for a stroke patient, and coping with the unpredictability of a patient's prognosis. The pandemic has precipitated shifts towards telehealth, but our study highlights the importance of avoiding marginalization of the elderly and less technologically inclined populations. Tables to be presented: Disclosures: U. Mahajan: None. N. Sharma: None. M. Maynard: None. L. Kang: None. C. Labak: None. M. Sajatovic: None. A. Hoffer: None. B. Shammassian: None. J. Wright: None. X. Zhou: None. C. Wright: None.