Mount Sinai Health System physicians formed a 24/7 telemedicine-based palliative care support line for COVID-19 patients at six of the New York City-based system's hospitals, according to a May 12 NEJM study.
The Icahn School of Medicine at Mount Sinai began planning for the hotline, dubbed PATCH-24, on March 23 and deployed it three days later. The support line served 873 COVID-19 patients over a four-week period.
Initially designed as a way for palliative care clinicians to offer support and coaching to emergency department and intensive care unit front-line clinicians, PATCH-24 was changed within one week to a telemedicine support line for families of COVID-19 patients. This palliative medicine clinician-to-family approach allowed families of COVID-19 patients to discuss goals of care with clinicians who specialize in palliative medicine.
"Changing to a telemedicine role required our palliative physicians to adopt new practices as they could not be physically present at patients' bedsides and were under considerable time pressures due both to patient volume and the speed at which decisions needed to be made," the study authors wrote.
PATCH-24 comprises two board-certified palliative medicine physicians who alternate 12-hour shifts. After experiencing exponential growth in call volume during the first week of the program, PATCH-24 expanded to include a backup pool of five physicians who helped take calls when multiple calls occurred simultaneously. Mount Sinai also trained a group of medical students to help field calls.
The study authors concluded that the PATCH-24 call line approach is useful for responding to COVID-19 and can also help hospitals looking to expand palliative care services beyond what is possible with a traditional inpatient consulting team.