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Last June, an image of an ICU bed in front of the Somorrostro beach in Barcelona made international news. The photo depicted Isidre Correa gently propped up in his hospital bed, accompanied by staff in full pandemic protection equipment. Isidre, who was admitted with Covid-19 in April, had spent two months within the intensive care unit – the sunlight and the sea air were considered part of his treatment.
This week, an image of a mother with her baby was captured in almost the same spot. Admitted to Hospital del Mar on 4 January, Shamaila, who was heavily pregnant, had tested positive for Coronavirus. Two days later her baby was delivered by Caesarean and, although the new-born was in good health, Shamaila’s condition was deteriorating – resulting in her admission to the ICU. After three weeks of separation, baby and mother were finally given the chance to reunite when hospital staff wheeled her bed onto the Passeig Marítim in Barcelona.
Hospital del Mar has taken advantage of its proximity to the sea for quite some time. The cases of both Isidre and Shamaila are examples of the hospital’s Humanisation of Intensive Care Program – which allows for ‘outings’ to take place, providing that the experience will favour the recovery of patients. Strict medical criteria and protocol are followed, ensuring that the patient’s condition is stable enough, as well as obtaining prior consent from family members.
The program is part of a recent approach to understanding and improving intensive care practices. In 2014, Spanish doctor Gabriel Heras, specialist in Intensive Medicine, created the International Research Project for the Humanisation of Intensive Care Units (HU-CI Project).
In past decades, incredible scientific and technological advances in ICUs have resulted in increased survival rates for patients admitted to these units. However, the HU-CI Project argues that the intensive use of technology has meant that the human and emotional needs of patients, families and professionals has taken a back seat.
The HU-CI Project highlights the necessity to ‘bring about the re-humanisation of medical care and improve the relationship between patients, relatives and healthcare professionals’.
Research to date has considered numerous aspects for improvement: flexibility of visiting hours and adaptation to individual needs, improvement of communication with patients, families and among professionals, guaranteed comfort of the patient, both in the physical, psychological, spiritual and environmental aspects, family involvement in the care and presence in the procedures, prevention, and management of burn-out syndrome in ICU professionals, among other lines of investigation.
To date, the HU-CI Project has been responsible for training over 10,000 health workers, impacting ICU practices on a global scale.
Since 2018, Hospital del Mar has committed to improve the experience of critically ill patients and their families by identifying their needs and demands. A project that, as explained by Dr. Joan Ramon Masclans, head of the Intensive Care Unit, and Desirée Ruiz, head of the Service Nursing Unit, seeks to change the vision and operation of these units: ‘Until now, the ICU was a cold, closed place, destined to save lives. Now it is a place that continues to be destined to save lives, but assuming that these are difficult times for the patient and families, making it more welcoming for all of them from both a medical and personal point of view.’
The objective of increasingly humanising the Intensive Care Unit at Hospital del Mar has evolved by several means. Waiting rooms are now considered ‘living rooms’ where family members can spend time in a more comfortable and pleasant space. Concerts have also taken place in the ICU, with students from the University of Barcelona’s MA in Music Therapy collaborating with the hospital. Emotional support services have also been organised for family members as well as patients who are discharged from the ICU.
The initiatives underway in Hospital del Mar have, of course, been affected by complications due to the pandemic. For the meantime, controlled outings to the seafront have allowed some degree of release and humanisation in what continues to be an incredibly tough period for ICU patients, their families and hospital staff.
La Shamaila ha pogut retrobar-se amb la seva família i el seu nadó, després de passar gairebé tres setmanes ingressada a l'#UCI per la #COVID19. Gràcies als professionals de @mar_uci, ho ha fet davant el mar @Judith_Marin_C @jrmasclans @Desireeruizs #humanització @HUMANIZALAUCI pic.twitter.com/liI3rgTcIj
— Hospital del Mar (@hospitaldelmar) January 26, 2021
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