Transylvania Regional Hospital Rolls Out Innovative “Beyond the Mask” Program to Enhance Caregivers’ Connections with Patients during COVID-19

Michele Pilon

Michele Pilon

By Michele Pilon, MS, BSN, RN, NE-BC

It’s hard to come up with an area of our lives that COVID-19 hasn’t touched. Gathering with friends and family in our homes and in public places became a thing of the past, as did going to the movies, attending sporting events and even browsing around your favorite boutique.

A byproduct of the pandemic that none of us has escaped is, unfortunately, isolation, and when we do go out in public to do something essential, like purchase groceries or go to a doctor’s appointment, masks are an added barrier between ourselves and others. Though masks are proven to greatly reduce the risk of virus transmission, they obscure half of a person’s face and make it harder to hear and understand what they’re saying, which poses real challenges in clinical settings, like the hospital.

The caregiver-patient relationship is one where trust is absolutely essential, and the patients at Transylvania Regional Hospital [1] (TRH) need authentic connection with their caregivers now more than ever, since visitors at various times have been either limited or not allowed at all in the hospital. Fortunately, we can now allow two visitors in with admitted patients and emergency patients, as well as one visitor with outpatients. In addition, we’ve rearranged our waiting areas to accommodate this more safely. No matter how positive an experience a hospital stay is for a patient, it is stressful and it can be even be frightening at times, when things are moving fast, like in an emergency treatment situation. When a patient is denied chances for interaction, this understandably makes them anxious.

In order to alleviate the problems that arise from the challenge of our providers having to conduct all their interactions with masks — and working with patients who are all masked as well — we have rolled out the innovative Beyond the Mask program, which aims to enhance connection between patients and caregivers by providing caregivers with an added, more personal layer of identification: In addition to their standard hospital identification badges, each team member wears another badge that features a photo of them smiling without their mask, and even if a patient is isolated, they will have an opportunity to see their caregiver’s smiling face via a posted picture in the room. Patients can then better see what their caregiver looks like, which is likely to increase their comfort. Currently, nurses and care technicians are participating in the program, however, the goal is to implement it hospital wide.

In addition to this visual cue, Beyond the Mask staff training also includes nonverbal and physical ways to communicate with patients, such as:

We saw how important it could be for TRH to adopt Beyond the Mask as we observed how obscured the person shrouded in personal protective equipment (PPE) could be. The strategies we use in this program are meant to show patients that there is indeed still a human being caring for them, even if it feels very different now. When they know this, we believe that they trust their caregivers more and hopefully feel less anxious.

Since we rolled out Beyond the Mask, we’ve gotten positive feedback from both our patients and caregivers. The steps that we have put in place do much to mitigate the alienation and loneliness the pandemic has visited upon our patients, and since the wish of our caregivers is to deliver the most compassionate care possible, the program helps them feel better about their work too.

The word “unprecedented” has been used a lot over the last year, regarding the way COVID-19 has changed how we live and work. Hopefully one day in the not-too-distant future, there will be more normalcy to our daily lives and in the world of medical care. We can all do our part by continuing to practice the 3 Ws: Wear a mask over your nose and mouth, wash our hands frequently or use hand sanitizer, and wait six feet apart. Lastly, when it’s your turn, receive the vaccine.

Until then, we will do all we can to make our patients comfortable and continue devising creative solutions to the challenges that the pandemic has presented. Our caregivers are still giving their all to TRH’s patients, and that will always be the case, whether they’re suited up in layers of PPE or not.

Transylvania Regional Hospital


Michele Pilon, MS, BSN, RN, NE-BC, is the Chief Executive Officer and Chief Nursing Officer of Transylvania Regional Hospital.

Transylvania Regional Hospital, [1] a member of Mission Health, an operating division of HCA Healthcare, is a full-service community hospital serving Transylvania and the surrounding counties. Located in Brevard, North Carolina, the hospital offers 25 inpatient rooms and 10 transitional care unit rooms. Transylvania Regional Hospital offers comprehensive services representing a full spectrum of specialties. Transylvania Regional Hospital was recently named one of the Top 20 Critical Access Hospitals in the United States.