Arris Steven M, Fitzsimmons Deborah A, Mawson Susan
School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, South Yorkshire, S1 4DA, UK.
School of Health Studies, Western University, London, ON, N6A 3B4, Canada.
BMC Palliat Care. 2015 Apr 30;14:17. doi: 10.1186/s12904-015-0012-4.
The challenge of an ageing population and consequential increase of long term conditions means that the number of people requiring palliative care services is set to increase. One UK hospice is introducing new information and communication technologies to support the redesign of their community services; improve experiences of existing patients; and allow efficient and effective provision of their service to more people. Community Palliative Care Nurses employed by the hospice will be equipped with a mobile platform to improve communication, enable accurate and efficient collection of clinical data at the bedside, and provide access to clinical records at the point of care through an online digital nursing dashboard. It is believed that this will ensure safer clinical interventions, enable delegated specialist care deployment, support the clinical audit of patient care and improve patient safety and patient/carer experience. Despite current attempts to evaluate the implementation of such technology into end of life care pathways, there is still limited evidence supporting the notion that this can be sustained within services and implemented to scale. This study presents an opportunity to carry out a longitudinal evaluation of the implementation of innovative technology to provide evidence for designing more efficient and effective community palliative care services.
A mixed methods approach will be used to understand a wide range of organisational, economic, and patient-level factors. The first stage of the project will involve the development of an organisational model incorporating proposed changes resulting from the introduction of new novel mobile technologies. This model will guide stage two, which will consist of gathering and analysing primary evidence. Data will be collected using interviews, focus groups, observation, routinely collected data and documents.
The implementation of this new approach to community-based palliative care delivery will require significant changes to established working patterns. This new service delivery model is being developed by the Hospice in collaboration with a team of international academic, industry, and clinical commissioning service improvement specialists. The findings from this initial evaluation will provide valuable baseline evidence regarding the delivery of palliative and end-of-life care services.
人口老龄化的挑战以及由此导致的长期病症增加意味着需要姑息治疗服务的人数将会上升。英国一家临终关怀医院正在引入新的信息和通信技术，以支持其社区服务的重新设计；改善现有患者的体验；并能够高效且有效地为更多人提供服务。该临终关怀医院雇佣的社区姑息治疗护士将配备一个移动平台，以改善沟通，在床边实现准确且高效的临床数据收集，并通过在线数字护理仪表板在护理点访问临床记录。人们认为，这将确保更安全的临床干预，实现专科护理的合理调配，支持患者护理的临床审计，并改善患者安全以及患者/护理人员的体验。尽管目前有人试图评估此类技术在临终护理路径中的实施情况，但仍缺乏证据支持其能在服务中持续实施并扩大规模这一观点。本研究提供了一个机会，对创新技术的实施进行纵向评估，为设计更高效且有效的社区姑息治疗服务提供证据。
将采用混合方法来了解广泛的组织、经济和患者层面的因素。该项目的第一阶段将涉及开发一个组织模型，纳入因引入新型移动技术而产生的拟议变革。这个模型将指导第二阶段，该阶段将包括收集和分析主要证据。数据将通过访谈、焦点小组、观察、常规收集的数据和文件来收集。
这种新的社区姑息治疗提供方式的实施将需要对既定的工作模式进行重大改变。这种新的服务提供模式是由临终关怀医院与一组国际学术、行业和临床委托服务改进专家团队合作开发的。这一初步评估的结果将为姑息和临终护理服务的提供提供有价值的基线证据。
