A pre-post evaluation of a telehomecare program in oncology and palliative care.
The purpose of this study was to evaluate the effects of a telehomecare intervention implemented in an oncology and palliative care unit in Quebec, Canada. As part of the intervention, nurses working within the oncology and palliative care program were given a tablet PC to use during patients' home visits and capture data related to the patient's encounter. Outcomes of interest were nurses' satisfaction with the software application, perceived quality of care, and individual and group productivity. With regard to productivity, we hypothesized that this system use would increase (1) the number of patients treated by all the nurses involved in the program, (2) the average number of home visits made by a nurse per shift, and (3) the percentage of time nurses spent providing direct care to patients. There was no intention to reduce the number of home visits made to individual patients. In order to assess the effects of the intervention, data collection was performed over three periods, representing the pre-implementation phase and two post-implementation phases, over 8 months. Data were collected using semistructured interviews, questionnaire surveys, and available documents. Findings revealed that nurses showed a positive attitude toward the software application and were satisfied with the quality of the information stored in the system, which appeared to be of great value for recalling patient information during a visit. According to the nurses, the clinical information system increased the completeness and quality of their interventions in the patient's home, mostly in terms of patient assessment, treatment, and education. Finally, in terms of productivity, we observed a significant increase in the number of patients treated by all the nurses (p = 0.04), the average number of home visits made by a nurse per shift (p = 0.02), and the percentage of time spent by nurses providing direct care (p = 0.003). In summary, the telehomecare intervention produced several positive effects that were related to nurses' quality of documentation and productivity.
Paré
Guy
G
Information Technology in Health Care, HEC Montréal, Québec, Canada. guy.pare@hec.ca
Sicotte
Claude
C
Chekli
Mohamed
M
Jaana
Mirou
M
De Blois
Céline
C
Bouchard
Martine
M
D004526:Efficiency; D018575:Home Care Services, Hospital-Based; D006801:Humans; D009369:Neoplasms; D010166:Palliative Care; D015397:Program Evaluation; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D017216:Telemedicine