Returning to in-home visits: Flexibility is key to safety
July 20, 2021
With national vaccination rates increasing and coronavirus cases decreasing, FCI has authorized a return to in-home support. Family Connects sites are exploring what this looks like for their communities. For sites that launched during the coronavirus pandemic, it will be the first time they’re visiting families in person. “It is a big adjustment,” says Emily Wright, Acting Director of Nursing. “We are recommending a gradual approach, especially for sites new to in-home visits.”
Local regulations differ and disease prevalence can change quickly, so FCI’s guidance emphasizes flexibility and prioritizes safety for nurses and families. After a site’s home agency and local health authorities approve in-home services, each site can select a visit format appropriate for their community. Most sites intend to conduct full in-home visits. But several sites are introducing a hybrid visit first, where much of the visit remains virtual and the in-person portion of the visit will be limited to brief physical assessments. In some communities the in-home segment is only for those families designated as high risk; other communities will offer brief in-home assessments to all families. FCI continues to support virtual visits as determined by the site or for those families who decline in-person services.
Family input informs hybrid stages
In addition to consulting CDC and OSHA recommendations, FCI surveyed families who received a recent virtual visit to determine whether they would have been comfortable receiving the visit in person. Visit length is a factor. Whereas 53% of families would be comfortable with a 90-120 minute in-home visit, 68% would be comfortable with a hybrid visit that included only 15-20 minutes in-person for physical assessments. A majority of caregivers also indicated that they would be more comfortable if nurses wear appropriate personal protective equipment or are fully vaccinated. Among other precautions, FCI is requiring the former and strongly recommending the latter.
Emily adds that even though the past 15 months have shown the value of virtual screenings, many nurses are looking forward to seeing families in person again. “Being with a family is special, and nurses learn so much when seeing a family in their home environment. Making the drive demonstrates how important they are to the community,” she says. “Each family is worth the trip.”
The Impact of COVID-19 on Family Connects
April 12, 2021
In 2020, we learned the answer to a question we never imagined asking: What do we do when in-home nurse visitors can’t visit families in their homes?
Thankfully, FCI has an incredible team who quickly developed and rolled-out a telehealth program to all Family Connects sites. And dedicated Family Connects nurses and staff wasted no time in adopting telehealth as a means to serve families during this challenging time. Still, the pandemic had a big impact on our ability to reach families with newborns.
The number of families who could be invited to receive a visit dropped significantly. Many Family Connects sites are part of local public health departments. This means that nurses have been pulled from Family Connects work, and some sites temporarily shut down their Family Connects programs to focus on the pandemic response. Due to COVID-19 restrictions, Family Connects also has been unable to visit birthing hospitals to tell families about the service and schedule a visit. New protocols had to be worked out with each hospital, and it became harder to connect with families.
In spite of these challenges, 12,514 families received Family Connects support in 2020. And while the number of families who scheduled visits decreased, the rate of families who completed their visits increased. In addition, families have reported being highly satisfied with Family Connects, despite the virtual delivery of visits.
The best news is that we continue to grow in our effort to ensure that all children and their families have access to community-based care that supports their health and well-being! Family Connects is currently being implemented in 22 communities, in planning with 15 additional communities, and in early discussions with several more.
Supporting Families During the Pandemic
January 7, 2021
In Santa Barbara, CA, families are offered virtual visits through a variety of platforms — like FaceTime, Zoom, and WhatsApp — as well as over the telephone. The Family Connects team has seen the needs of their families intensify, with the emotional stress of COVID beginning in the hospital where stays have been shortened and supporting visitors have been limited to one person. The emotional impact on parents has been profound, making connections and referrals to resources even more critical. When the team in Santa Barbara learned that many families were choosing to delay the first pediatric visit due to COVID concerns, they implemented a program to loan baby scales (with consultation and follow-up), so that parents could monitor their infant’s weight and ensure the baby is making sufficient gains. They’ve also created online lactation discussion and parent discussion groups, giving parents the opportunity to ask questions and share experiences on an ongoing basis.
In late March, as the novel coronavirus pandemic began its crescendo, Family Connects International advised all Family Connects sites to begin delivering nurse home visits via telehealth and telephone. This was no small endeavor. New protocols and new ways of reaching-out to families with newborns had to be developed quickly, but a strong commitment to serving families with newborns informed all discussions and planning.
Since face-to-face outreach in hospitals is currently prohibited as a safety measure, nurses are reaching out to mothers by phone to explain Family Connects and schedule a telehealth visit. Consent forms are completed electronically and nurses conduct visits through a variety of platforms, like Google Hangout, Zoom, or a simple phone call.
At Family Connects Chicago at Rush University Medical Center, nurses made their first telehealth visits on March 23. “I’m just astounded by the high percentage of women who accept the virtual visit – 93% of women who pick up their phone and hear about the program accept the visit,” says Jennifer Rousseau, Assistant Professor of Nursing at Rush.
Because of fears of coronavirus exposure, some parents are reluctant to take their newborns to their first pediatric appointments. Additionally, many small pediatric practices have had to temporarily close their doors. Telehealth visits from Family Connects nurses not only offer reassurance to families, but also provide an opportunity to connect caregivers to a pediatric medical home and get appropriate care for their infants.
Of course, there have been challenges. Some locations had to resolve information technology issues with new platforms or connectivity. Community alignment staff are figuring out how to build virtual networks with community partners and navigate the impacts of a changing landscape of services. And for others, adjusting communication styles to suit a virtual visit took practice.
But Family Connects staff have risen to the challenge, demonstrating creativity and passion. In Santa Barbara, for example, Family Connects staff developed an online lactation support group. Family Connects North Texas created drop in “baby cafés” – a virtual space for families to connect with and support each other. Several Family Connects sites are offering interactive video support sessions covering topics such as safe sleep and infant crying, and many Family Connects nurses drop-off diapers and other resources to families in need.
In times of crisis, relationships and support — even when virtual — make all the difference.
(Pictured are Kathryn Kaintz and Darlene Hepburn of Family Connects Chicago at Rush University Medical Center)
Family Connects Portraits: The Scheckter-Soliah Family
After the birth of their first daughter in 2014 in Durham, NC, Rachel Scheckter and James Soliah were introduced to Family Connects by an outreach coordinator during Rachel’s hospital stay. They both thought it sounded like a great idea. Living far away from their families brought anxiety – Rachel and James knew they’d be on their own when they took baby Eleanor home. Because James got no parental leave, Rachel feared she’d become isolated, trapped at home during the coldest weeks of winter. They looked forward to the visit from the Family Connects nurse, who arrived about three weeks later.
“By the time I became a parent, I had experience working as a doula, had a Master’s degree in maternal and child health, and was a certified lactation consultant,” Rachel said, “Even with all that knowledge and experience, there were things about becoming a parent that I wasn’t prepared for.”
While the idea of a home visit may at first seem uncomfortable or even overwhelming at a time when new parents are already juggling so many things, Rachel says the visit actually made her feel less overwhelmed. A visit to her own home meant that Rachel didn’t have to worry about bundling-up the baby or driving on icy roads to try and make an appointment time. It didn’t matter if the baby was asleep or if Rachel was in pajamas when the nurse arrived. This was a relief.
The health check on baby Eleanor was also a relief because she’d been born very small and Rachel was working through breastfeeding challenges. The Family Connects nurse was able to spend time understanding what Rachel’s family needed in terms of support. She listened and didn’t make assumptions.
“When a baby is born, it’s really not just the baby that’s born,” Rachel said, “A new mom and a new family are born, too, and they need an equal amount of support to grow and thrive.” When Rachel and James welcomed their second daughter in 2017, Family Connects visited again. Though they had much more confidence as parents the second time around, Rachel appreciated the reassurance and help she got from the nurse. They were able to talk about the new family dynamics that the arrival of baby Clara would bring. And Rachel learned about new community services that she was not aware of.
“Family Connects provided reassurance and cared for our whole family in a way that all new families need and deserve,” said Rachel.
Family Connects National Snapshot (August 2021)