Every day, hospital waiting rooms fill with people waiting anxiously for news on a loved one having surgery. The relatives read magazines, fidget with their cell phones, visit the cafeteria, pray. Above all, they watch for the surgeon to come and tell them how it went.
Mauricio J. Garrido knows how stressful the wait can be, having endured it at age 14 when his father had successful coronary artery bypass surgery.
Now a cardiothoracic surgeon at Abington Hospital-Jefferson Health, Garrido and two co-workers have developed a program that allows family members to receive news from heart surgeons still in the operating room — through a high-definition webcam and video conferencing software. Surgeons let family members know when a patient has safely made it through the most critical part of an operation and the surgery is wrapping up. This can trim an hour or more off the time it would normally take for the surgeon to meet the family, though the doctor still does that as soon as possible.
“The last 30 to 60 minutes of the family waiting is when the anxiety exponentially climbs,” Garrido said. But when he gives them good news about an open-heart surgery from the operating room, he can “see them visibly relax.”
On a recent Monday at Abington, 50-year-old Charlotte Fogle, of East Oak Lane, sat with friends as she waited for word on her fiancé, Lewis Jenkins, 61, who was having a left ventricle assist device implanted to assist his failing heart. The L-VAD, as the battery-powered pump is called, will help his heart circulate blood, while he hopes for a heart transplant, though many people live with the devices long term.
While she waited, Kevin Hagan, manager of the hospital’s mechanical cardiac assist program, which oversees the L-VAD devices, stopped by.
Fogle told him she was drained from worry and lack of sleep leading up to the surgery. Jenkins had gone into pre-op at about 7:30 a.m. About noon, she got a call that the operation could be a while longer. Then, less than an hour later, a surgical clerk took Fogle to Jenkins’ room in the intensive-care unit, where an iPad was set up so she could see and talk to the surgeon in the operating room. On the screen, Garrido told her that Jenkins was doing well and would soon be out of surgery. She started to cry.
“I’m so glad that is just about over. I’m happy,” Fogle said. “It was nothing but love and pure devotion,” she said of the team’s care for her fiancé. “That’s all you want with this type of surgery.”
The camera and video monitor in the operating room also can help the surgeon consult with off-site specialists, who can offer their opinion without needing to come to the hospital, said Linda Millevoi, hospital spokesperson.
Cardiovascular nurse Michele Boyle said that the surgeons also use the electronics to give staff outside the OR a list of necessary supplies and instructions to care for the recovering patient, even before leaving the operating room.
The service is part of the system’s focus on telehealth, said Rohinton Morris, chief of the division of cardiothoracic surgery for Jefferson Health. The health system also has initiated videoconferencing for patients to have free mini-consults with Jefferson doctors through a program called JeffConnect.
“For the most part, it’s been a huge hit,” Morris said.
Abington is the first hospital locally to offer telehealth service from the operating room. If it continues to be successful, Morris would like to implement it at other cardiac surgery sites affiliated with the Jefferson network.
For all types of surgery, Abington and several other area hospitals also use electronic status boards that show whether a patient is in pre-op, the operating room, or the post-op recovery unit. Some, such as Temple University Hospital, give the patient’s family a coded number to check. At Children’s Hospital of Philadelphia, the patient is identified through initials and birthday.
But the hospitals also try to humanize the experience by sending nurses or other staff members to check in with families.
“Communication is one of our biggest priorities,” said Susan Kamerling, a family-care specialist at CHOP. “Two nurses act as liaisons with a goal to update the family every hour. … We’re a direct link from the operating room to the family. This is the one place where they can’t be with their child.”
Dekeisha Howard, who manages the Perianesthesia Care Unit at CHOP, from which patients go into or come out of surgery for all but cardiac cases, said a team of family-care specialist nurses update families during the surgery. The hospital has five consulting rooms where surgeons meet with family members after the surgery.
Garrido said the video conferencing approach, which he developed with fellow Abington staffers Charles Yarnall and Justin Kuprevich, was an extension of Jefferson’s commitment to family care.
“Our team puts their souls into what we’re doing,” he said.