Top: Heather McEachern (Richmond), Jenna Jangalee (VGH), Respiratory Therapists Bottom: Nicole Warren and Hannah Fisher, Physiotherapists at St. Paul's Hospital
When COVID-19 restrictions hit in March, one of the many programs impacted was the Pulmonary Rehabilitation Service Program. The program supports patients living with chronic lung disease — ranging from asthma to chronic obstructive pulmonary disease (COPD) to pulmonary fibrosis — and focuses on education, exercise and fostering connections to community resources, with each Vancouver Coastal Health (VCH) site delivering slightly unique versions of the program.
Participants work with a variety of clinicians including physiotherapists and respiratory therapists who guide them through appropriate exercises in a small group setting. But when COVID-19 struck, it was no longer appropriate for groups of outpatients with chronic respiratory issues to meet in person for their weekly exercise routine.
“There's a lot of underlying anxiety and depression in people living with chronic lung disease," says Jenna Jangalee, Respiratory Therapist with the VGH Pulmonary Rehab Program. “Add social isolation on top of that and it definitely causes concern, which is why we knew we had to do something. We couldn't just have our participants lose this service for the foreseeable future."
Teams across all sites — Richmond, Coastal, Vancouver and even PHSA — joined forces to quickly figure out how to move their programming online. There were many things to consider, such as how to keep patients safe, what kind of exercises could be done from home and how to make people feel comfortable using technology. Within a couple of weeks, some of the sites were up and running, offering educational lectures and exercise classes via Zoom.
“Having to move to a virtual method of delivery sparked an amazing collaboration between all these sites which was exciting to see," says Arlene Singh, Virtual Health Clinical Planner. “The teams worked together to develop a relatively standardized way of delivering their exercise program over Zoom and everyone truly benefited from sharing their ideas during a time when everything felt uncertain."
To date, the programs have seen great success and positive feedback. Staff have stepped up to find creative solutions to new challenges, such as sending out instructions on how to make weights with rice and water and offering virtual assessments to newcomers.
“I was so impressed with our clients who persevered with their virtual sessions," says Heather McEachern, Respiratory Therapist with the Richmond Pulmonary Rehabilitation Program. “I could tell our older population felt empowered and pleased with themselves for being able to overcome some of their initial hesitance and ended up comfortably participating virtually."
While there are certainly benefits to having an in-person exercise program, both Jenna and Heather agree that the virtual program helps to remove barriers that some participants used to face, such as having to take transit or pay for parking.
This was the case for Vancouver General Hospital (VGH) participant Holly Shaw, who lives in Ladysmith on Vancouver Island and is living with pulmonary fibrosis. With no pulmonary rehabilitation program nearby, she made the decision a few years ago to stay with her daughter in Vancouver so that she could access the VGH program and was only able to complete the first session. Now that the program is online, she is once again able to join from the comfort of her home.
“The program is amazing and having it online through Zoom has allowed me to participate again, which I'm just thrilled about," says Holly. “A couple of us who met in the program have also moved our support group online which has really helped me to reconnect with them because before it was a lot for me to come into Vancouver to meet with them."