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29 Overcoming resistance to change: how COVID-19 enabled a hospice quality improvement digital health intervention project
  1. Michele JM Wood1,
  2. Adam Levene1,2 and
  3. Sarah Greaves3
  1. 1Marie Curie Hampstead Hospice, London Place, UK
  2. 2St Peter and St James Hospice, Lewes, UK
  3. 3Marie Curie Newcastle Hospice, UK


Introduction Implementation of new ways to deliver patient care requires organisational ‘sign-off’. Proposals made in 2014 for an online art therapy group for housebound patients met barriers of: insecurity of the online platform; concerns that patients lacked IT knowledge, skills and devices; limited staff time and no clear policy integrating the online intervention with a patient’s care package. In 2019 the project was agreed as a Quality Improvement (QI) pilot but halted when COVID-19 suspended out-patient services. Remote working with patients using MS Teams meant that previous guidance preventing video calls with patients was changed. The COVID-pandemic and lockdowns highlighted the value of online psychosocial support for patients isolated at home. Homeworking of staff paralleled patients’ experience; staff wellbeing during lockdown became an issue.

Aims To implement the QI pilot of online group art therapy with Marie Curie staff volunteers.

Method A total of 35 staff volunteered to test the format. The platform used was Microsoft Teams, qualified Art Therapists following professional and organisational guidelines facilitated. A Plan-Do-Study-Act approach allowed feedback from participants in one group to shape subsequent iterations. There were three PDSA cycles.

Results Teams was an acceptable platform. MC staff volunteers and lay representative joined from across the UK. Participants identified key practical features to improve the format, reporting the intervention as personally supportive.

Conclusion The COVID-19 pandemic unlocked organisational barriers to delivering psychosocial support by videoconferencing. This QI pilot helped refine the art therapy group format, indicating a meaningful online therapeutic engagement was possible. It confirmed a protocol for a novel intervention ready to use within MC for service users and staff wellbeing.

Impact Learning from this project will inform innovations in psychosocial support for patients and staff as hybrid-virtual services develop for palliative care post-COVID-19. Its positive outcomes reinforce existing evidence that group online art therapy is helpful but requires organisational buy-in.

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