Change of Care for Rush Day Hospital Patients

Cheryl Siegall, MS, RN, PMHCNS-BC, Unit Director, Dee Dee Sanford, MBA, BSN, RN, PMH-BC, AUD, Kevin Pittman, BSN, RN, PMH-BC, RN3, Chris Spaletto, ATR, Peter Munro, LCSW, Lynnsey Cline, LCSW, Peter Fink, MD

The Rush Day Hospital (RDH) is a premier mental health program for the treatment of individuals with affective and anxiety disorders, personality vulnerabilities, and other complex and treatment-refractory conditions that can interfere with relationships, daily living and role functioning.

Recipients of treatment at RDH receive individualized attention in a dynamic, intensive group process within the setting of a supportive therapeutic community. Every Monday through Friday, staff provides group therapy for 25 to 35 of our 40+ patient communities in our spacious group room and art studio.

In March of 2020, though, with the COVID-19 pandemic, large in-person groups were becoming a physical health risk and change needed to occur.

On March 17, the RDH staff group met to discuss that we could no longer meet in person due to threats of increased spread of the virus amid medically compromised individuals. On March 18, we made early calls to our patients to inform them the program would not be going on in person.

Meanwhile, as events were unfolding, we were searching for a more innovative, sustainable way to treat our patients, as daily phone checks were not sufficient to meet the needs of patients.

The things we all needed to do to manage the spread of COVID-19 were quite the opposite of what we typically tell our patients: “Don’t isolate, don’t be alone, get out of your house or apartment, socialize, spend time with other people.” They were going to need the program now more than ever.

Quickly we learned that there were online formats becoming more available with the help of government entities and lawmakers and we knew there was a way to do the program differently for a while.

Regulations were relaxing to allow health providers to use a number of virtual methods in order to address patient needs during the pandemic. VidyoConnect, a virtual platform used for meetings, is capable of working with other electronic programs, including the Epic and MyChart systems, to provide enhanced safety and confidentiality due to its encrypting capacity. The service is now being used by RUMC across the system to provide telehealth “rooms” for clinicians to meet with patients online and provide services with visual and audio capacity in real time. Across the hospital, patients enter these virtual treatment rooms hosted by their clinicians via an appointment scheduled in MyChart.

For RDH, VidyoConnect mimics the program’s group rooms, providing sufficient online space for our large group community. It allows for up to 16 individuals to be seen at one time on a large screen and for staff to navigate the attending participant list, observing and responding to others, so that all may be seen and participate in the group. Every morning, patients enter the group room via their scheduled appointment in MyChart to participate in therapy.


On March 26, with all patients sheltered in place, a new chapter via VidyoConnect began for the Rush Day Hospital partial hospitalization program (PHP), intensive outpatient program (IOP) and group therapy programs. The week of April 13, the first two participants experienced the program in the virtual format.

A total of six new participants started in the 4th quarter of FY 20 compared with five new participants in the 4th quarter of FY 19. We also had four graduations in the same quarter, compared with six graduations in FY 19.

The most important outcome of this innovation has been our ability to keep the program going and continuing to provide treatment seamlessly. Even with the turmoil of having to cease meeting in person, and switching to the video format, our daily census remained higher for the fourth quarter of FY 20.

Additionally, comparing the fourth quarter of FY 20 to the fourth quarter of FY 19, the average daily census for each of the three months is nearly identical.

Daily census graph