Quintin, a Double Robotics robot that looks like a computer tablet on wheels, has been equipped to do video and voice calls using the freely available WhatsApp service, or regular phone calls.
That means family members can now dial in to “visit” with patients in the Covid-19 ICU.
Quintin can be remotely steered using an app and therefore hospital staff don’t have to physically enter the ward to position the robot.
This reduces their risk of infection, saves on personal protective equipment (PPE) and frees up their time to focus on other tasks.
Enabling contact between patients and their families has been a “humanising process”, explains Dr Kerry Louw, a psychiatrist at Stellenbosch University’s Faculty of Medicine and Health Sciences (FMHS) and Tygerberg Hospital.
She likens the experience of being a patient in an ICU to “a form of psychological anguish which involves a fear of death, unexpected pain and sensory deprivation, as well as overstimulation”.
ICU patients are not only physically ill, but often also suffer psychologically because they are isolated from their families, are sleep-deprived due to the constant beeping of machines, and experience no natural light or air movement.
“Some patients stay in an ICU for long periods of time, and it becomes really difficult for them,” Dr Louw explains.
“It’s heart-warming to see the smiles once patients have connected with their families. It has made such a difference.
“In some cases, the patients have not been awake while the family communicates with them, but it has still been meaningful. We have been able to organise some end-of-life conversations for people to say goodbye. One family wanted to be present at the moment of passing and we enabled them to be there with the patient.”
Dr Louw says the Department of Psychiatry was already providing individual and group support for healthcare staff working with Covid-19 patients, when a colleague asked if they could help with patient family contact.
“Staff members of the department moved into a little office at the ICU to be on site to support the ICU staff. We go in every day to be visible to the staff and to give psychological support to the patients.”
When Quintin is called upon to assist, he moves over to the patient and sometimes stays with them for hours while the family visits virtually.
“I always explain to the families beforehand what to expect and what it looks like to see someone who is intubated, as it can be a shock.
“Some families don’t want visual contact and prefer audio contact. We always check in with the patient to see how they are doing after engaging with their families. We also check in with the families, who can be very emotional after they’ve connected with the patient,” says Dr Louw.
According to Professor Coenie Koegelenberg, an FMHS pulmonologist who also works in Tygerberg Hospital’s Covid-19 ICU, the idea of using Quintin in this capacity came about “because we didn’t expect the patients to be so aware, awake and anxious”.
“It is difficult for healthcare workers to provide psychological support through a mask and goggles, because you look like an alien and it is difficult to hear what people are saying,” he says.
Professor Koegelenberg originally sourced Quintin’s services to enable ICU specialists to do virtual Covid-19 ward rounds when they are unable to be physically present.
“The odds of at least one of us falling ill or having to go into self-isolation and being unable to physically go to work were quite high, so it was reassuring to know that we would be able to function remotely by using a phone or a laptop to steer the robot.”
None of the ICU specialists have fallen ill yet, but Quintin’s services as an intermediary between patients and their families have been indispensable.
Dr Louw says connecting the family who wanted to be present when their relative passed away was memorable and moving.
“We were able to have Quintin present while the family sang and prayed with the patient as he died. It was very powerful. It has been a huge privilege to engage with patients and their families at such a vulnerable time in their lives. It is beautiful, but hard,” says Dr Louw.