The coronavirus pandemic intensified the already pressing need for the communication and symptom management expertise of palliative care specialists. Amid the surge of COVID-19 cases in New York City, a team at the Icahn School of Medicine at Mount Sinai rapidly launched a novel 24/7 telephone line - PAlliaTive Care Help line (PATCH-24) - to provide support to patients and health care providers. The call line supported more than 800 difficult cases during the COVID-19 pandemic in late March and early April 2020, expanding access to specialist palliative care and prioritizing health system resources. PATCH-24 was initially intended to coach frontline teams on conducting goals of care conversations, but these teams had limited bandwidth to receive training while caring for high volumes of COVID-19 patients. As a result, PATCH-24 was shifted from a teleconsultation to a direct telemedicine model.
The authors outlined key principles that supported the PATCH-24 model. These principles addressed the importance of direct palliative clinician-to-family communication support, as well as using call volume to inform program and staffing changes. Notably, the call line provided valuable supports for distressed frontline clinicians. Lessons learned from this model may be relevant for hospital systems interested in planning for COVID-19 response or generally expanding palliative care.