Table 1 Overview of working strategies of FSTs

Key elements

Daily contact by telephone with all relatives of patients admitted to this hospital’s ICU with COVID-19 from mid-March until mid-June 2020.

Goal

To provide a daily update to relatives on the patients’ situation in order to reduce pressure on ICU professionals and to provide extra support to relatives

Responsibilities of involved team members

Members of the FSTs were not part of the clinical ICU team. Team members were assigned the task of communication with the first contact person under the authority of the treating physician, except for communication regarding critical decisions such as stopping respiratory support. The ICU physician was responsible for the first contact with the relatives and introducing the FST (relatives also received written information about the FST). FST team members were granted permission the access to electronic patient files by order of the head of the ICU.

FST hospital 1

Frequency and timing of communication

Daily telephone calls between 13:00 and 18:00 to the patients’ first contact person as mentioned in the patient file. Calls were also on weekend- and public holidays. Given information was based on the electronic patient file, in which the ICU specialist made a short note on the patients’ situation beforehand.

Team composition and working strategies

Members of the support team were a wide range of medical specialists (oncologists, anesthetists, neurologists, geriatricians). The support team was subdivided into five teams, of which each had found its own working method. Each team consisted of 4 or 5 doctors and was responsible for a certain number of families, guided by a team captain. Teams varied in composition (various medical specialist in one team or all the same medical specialists on one team) and strategy (teams who had a fixed contact person for a family or teams who had various contact persons for a family). The FST used guidelines for the conversations with relatives and a template for documenting conversations in the electronic patient file. They used a fact sheet and a list of frequently asked questions from relatives to make sure that the general information given to relatives was as consistent as possible. This information was updated regularly.

FST hospital 2

Frequency and timing of communication

The patients’ first contact person (as mentioned in the patient file) received a daily telephone call on a specific time of their preference. This could be either in the morning, afternoon or at night. Calls were also during weekends- and public holidays. Given information was based on the electronic patient file, in which the ICU specialist made a short note on the patients’ situation beforehand about the condition of the patients and other relevant information for the family.

Team composition and working strategies

Members of the support team were all experienced pediatricians who were guided by a team captain. ICU physicians reported family contacts of newly admitted patients to the team captain and informed the family about the support team. The team captain assigned one of the pediatricians to a family contact. Support team members called families on a daily basis and made appointments about timing and amount of calls with the family contact. Support team members used the short notes of ICU physicians in the electronic patient file as background for their daily calls. The ICU physicians was available by phone for extra information if needed. Before the team started, an online meeting was held for pediatricians in which ICU physicians explained the situation on the ICU and gave information about the clinical situation of COVID-19 patients.