![]() During past crises, the public reported relying on health websites and physicians as trustworthy information sources. In the last two decades, the internet has become a critical vehicle in communicating information during public health emergencies. The language health systems use to communicate such policy changes likely shapes public perceptions of inpatient health care facilities at a time when there is an increased need for urgent medical care. This recommendation reverses decades of policy and cultural evolution emphasizing the integral role of family members during inpatient care, based on research demonstrating that family presence during hospitalization improves patients’ and family members’ outcomes. The Centers for Disease Control and Prevention (CDC), the Center for Medicare and Medicaid Services, and national professional organizations recommended that health systems limit the presence of patients’ family members to reduce viral spread. One example of such a policy change is the restriction or elimination of family presence in inpatient settings. The facility expressed a high degree of ownership over the decision (OR 1.16, 95% CI 1.04-1.29), rather than a low degree of ownership and inclusion of family-centered care support plans (OR 2.80, 95% CI 2.51-3.12), rather than no such support.ĭuring the global COVID-19 pandemic, health systems rapidly changed procedures and policies to minimize viral transmission and accommodate increased patient volumes and illness acuity. Visitation policy elements significantly associated with willingness to recommend the facility included justifications based on community protection (OR 1.44, 95% CI 1.24-1.68) or scientific rationale (OR 1.30, 95% CI 1.12-1.51), rather than those based on a governing authority. ![]() A total of 1321 participants completed the web-based survey. Most of the policies analyzed used passive voice to communicate restrictions. A minority (38/104, 36.5%) addressed how restrictive visitation may impair family-centered care. Facilities justified the restricted visitation policies on the basis of community protection (59/104, 56.7%), authorities’ guidance or regulations (34/104, 32.7%), or scientific rationale (23/104, 22.1%). Most policies prohibited family presence (99/104, 95.2%). The mean Flesch-Kincaid Grade Level for the policies was 14.2. We identified 104 unique policies on inpatient visitation from 363 facilities’ websites. ![]() Our primary outcome was participants’ willingness to recommend the hypothetical facility using a 5-point Likert scale. The factorial survey-based experiment presented composite policies that varied in their justification for restricted visitation, the degree to which the facility expressed ownership of the policy, and the inclusion of family-centered care support plans. For the factorial experiment, US adults were drawn from internet research panels. ![]() For analysis of the policies, we included all inpatient facilities in Pennsylvania. We also conducted a factorial survey-based experiment to test how key elements of hospitals’ visitation policy communication are associated with individuals’ willingness to seek care in October 2020. We conducted a sequential, exploratory, mixed methods study including a qualitative analysis of COVID-19 era visitation policies published on Pennsylvania-based facility websites, as captured between April 30 and (ie, during the first peak of the COVID-19 pandemic in the United States). ![]()
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