Dr. Sabira Valiani: Creating Connections in Critical Care
Dr. Sabira Valiani (MD) was one of the frontline physicians working inside Saskatoon’s critical care units four years ago, during the initial lockdowns of the COVID-19 pandemic.
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“It was really weird,” said Valiani.
Valiani said ‘a lot of light bulbs went off in my head’ amid the automated stillness of the unit, as she watched ventilators breathing for heavily sedated patients.
Covered in head-to-toe personal protective equipment, staff in the intensive care unit struggled to simultaneously treat patients, communicate with family members, and enforce hospital policies.
“Those patients aren’t talking to us,” Valiani said. “It was empty, it was overwhelming and it was disconnected all at the same time.”
Valiani has now spent seven years in critical care, a move that started with her enrolling in a critical care and ICU elective in Ottawa.
“I loved it. I loved on the medical side, how you could see the life support that you were giving a patient immediately have a physiologic effect and stabilize that patient,” she said.
Driven by her experiences during the pandemic, Dr. Valiani delved into research focused on improving patient and family experiences in the ICU. She collaborated with a multidisciplinary team and patient partners to understand the challenges faced by healthcare providers and families alike.
In this article for the Canadian Association of Critical Care Nurses, she and her colleagues examined the effect of visitor restrictions during the pandemic.
In this episode, Valiani said she remembers tearful goodbyes, families gathered around screens, unable to hug or touch loved ones infected and dying with COVID-19.
"The family's role becomes significantly diminished,” she said. “So much of that was disrupted during that time."
In the months and years that followed, visitor restrictions relaxed, but Valiani noticed communication between families, patients and staff still felt awkward.
Valiani and her colleagues turned their lens last year to key moments for Canadians of diverse ethnicities during the critical care journey, in the Canadian Journal of Anesthesia. The findings revealed the strain on healthcare providers playing multiple roles and families feeling disconnected from crucial information.
She estimates 30 per cent of Saskatoon’s ICU patients travel from remote communities, making it crucial to find ways to keep family members informed in a language they understand well.
“People kind of naturally turned towards communication technology in the pandemic,” said Valiani, noting a number of families cannot be present in-person during the day, as intensivists attend rounds.
Clear and open communication between patients, care providers and families is the key, Valiani said.
“What if we could use artificial intelligence or AI to just translate a medical progress note into an understandable family update?” Valiani asked.
“It doesn't have to be high tech, right? Like it can be a phone call.”
Together with the Saskatchewan Health Research Foundation, Dr. Valiani now works at enhancing patient-family engagement through practical solutions. She emphasizes the importance of involving families in care decisions, acknowledging their unique expertise in understanding patients' wishes.
Her team presented its findings in 2022 at Toronto’s Critical Care Canada Forum.
“We have this cohesive approach to defining the problems,” said Valiani. “Now we can take this to decision makers and say….these are the things people living this experience actually want.”