Episode #36: We Need To Talk (Part II)
Dr. Lance Patak, MD joins us to discuss his work on communication in the ICU.
He explains to us the following obstacles we face in our patient care and tools that can enhance humane care and patient outcomes.
“Problem: Intubated COVID-19 patients recovering from days of paralysis are too weak to write legibly and cannot speak leaving them terrified, anxious and poised for days spent in delirium, complications, prolonged hospital stay and death due to excessive sedation requirements and other associated complications of delirium and prolonged critical illness.
Solution: Empowering intubated patients with an effective means to communicate reduces sedation requirements and redirects their recovery toward a faster, less complicated trajectory.
We have two communication solutions, the EZ Board (disposable, low tech) and VidaTalk (digital app) which have been shown to be effective with criticially-ill intubated patients. Dr. Mary Beth Happ led the NIH funded research (NR014087) at OSU which allowed us to ensure the VidaTalk application was able to successfully meet the human factor requirements for critically-ill, intubated patients, which is a huge feat. In this manner, the EZ Board and the VidaTalk app ensure many of the patients within this vulnerable patient population have an effective means to communicate their needs and symptoms to their care providers and loved ones while being intubated, and thereby reducing their need for sedation which is a primary outcome to reduce delirium, shorter lengths of stay, lower mortality and decreased healthcare costs.
Since the COVID19 breakout, hospital supply chains are unable to process PO’s for much needed equipment and supplies. Doctors and nurses are calling us asking how they can get communication resources without having to go through purchasing because of the urgency. We have resorted to bypassing traditional purchasing processes and have made the application and our other communication tools available for free worldwide.
Vidatak’s Press Release for Free Access
The amazing story here is we have laid the groundwork to ensure we have effective solutions available prior to a pandemic that would be intubating 10% of its victims. What is missing is a standardized process that requires providers to provide effective communication tools to intubated patients. While the ABCDEF Bundle, which was established to reduce the incidence of delirium, has shown promise, it falls short because systematically we do not monitor or care for communication impairment at any predictable level. Instead communication with these patients is an ad hoc emphatic act performed by few individuals who care enough to do it on their own accord.
Consequently, in light of the COVID phenomenon where nearly all of its intubated patients are rendered completely dependent on advanced communication aides to help them communicate once they are eligible for sedation weaning, very few of these patients are being provided the means to effectively communicate and their sedation requirements and exposure are doubling/tripling the rates of delirium and following that driving our high mortality rates.
Anyone can go to our website today, www.vidatak.com, and by entering a few login credentials, every hospital can immediately provide the VidaTalk application to their intubated patients right now. EVERY PATIENT CAN HAVE ACCESS RIGHT NOW. Achieving this type of immediate access to such a critical need is huge!
Dr. Mary Beth Happ and her research team at OSU have also made an evidence-based teaching curriculum (SPEACS-2) available at no cost so that providers worldwide would also be able to learn how to best use communication aids with these complex, critically ill patients.
Our budget has been depleted for this Program. In additional to revenue loss, cost of manufacturing and shipping, hospitals everywhere are requesting we add additional languages and new features to VidaTalk that enable remote video communication as well as adding links to video interpreter services. If there was ever a time our work became relevant it is now. Despite having to borrow to keep this Program open, we have extended it through to June 30, 2020. We have initiated a GoFundMe Campaign to help support this cause and best respond to the demand from front line providers.
