Bruyère Research Institute, Ottawa, Ontario, Canada.
Parsons School of Design, The New School, New York, New York, USA.
Health Expect. 2024 Apr;27(2):e14002. doi: 10.1111/hex.14002.
Returning home from the hospital for palliative-focused care is a common transition, but the process can be emotionally distressing and logistically challenging for patients and caregivers. While interventions exist to aid in the transition, none have been developed in partnership with patients and caregivers.
To undergo the initial stages of codesign to create an intervention (Advancing the Care Experience for patients receiving Palliative care as they Transition from hospital to Home [ACEPATH]) to improve the experience of hospital-to-home transitions for adult patients receiving palliative care and their caregiver(s).
The codesign process consisted of (1) the development of codesign workshop (CDW) materials to communicate key findings from prior research to CDW participants; (2) CDWs with patients, caregivers and healthcare providers (HCPs); and (3) low-fidelity prototype testing to review CDW outputs and develop low-fidelity prototypes of interventions. HCPs provided feedback on the viability of low-fidelity prototypes.
Three patients, seven caregivers and five HCPs participated in eight CDWs from July 2022 to March 2023. CDWs resulted in four intervention prototypes: a checklist, quick reference sheets, a patient/caregiver workbook and a transition navigator role. Outputs from CDWs included descriptions of interventions and measures of success. In April 2023, the four prototypes were presented in four low-fidelity prototype sessions to 20 HCPs. Participants in the low-fidelity prototype sessions provided feedback on what the interventions could look like, what problems the interventions were trying to solve and concerns about the interventions.
Insights gained from this codesign work will inform high-fidelity prototype testing and the eventual implementation and evaluation of an ACEPATH intervention that aims to improve hospital-to-home transitions for patients receiving a palliative approach to care.
Patients and caregivers with lived experience attended CDWs aimed at designing an intervention to improve the transition from hospital to home. Their direct involvement aligns the intervention with patients' and caregivers' needs when transitioning from hospital to home. Furthermore, four patient/caregiver advisors were engaged throughout the project (from grant writing through to manuscript writing) to ensure all stages were patient- and caregiver-centred.
从医院接受姑息治疗后返回家中是常见的过渡,但对患者和护理人员来说,这个过程可能会在情感上造成困扰,在后勤上带来挑战。虽然有干预措施可以帮助过渡,但这些措施都不是与患者和护理人员合作开发的。
进行初始的共同设计阶段,以创建一项干预措施(在患者从医院过渡到家庭时,通过推进关怀体验来改善接受姑息治疗的患者的体验),从而改善接受姑息治疗的成年患者及其护理人员从医院过渡到家庭的体验。
共同设计过程包括:(1)开发共同设计研讨会(CDW)材料,将先前研究的主要发现传达给 CDW 参与者;(2)与患者、护理人员和医疗保健提供者(HCP)进行 CDW;(3)进行低保真原型测试,以审查 CDW 的产出并开发干预措施的低保真原型。HCP 对低保真原型的可行性提供了反馈。
2022 年 7 月至 2023 年 3 月期间,有三名患者、七名护理人员和五名 HCP 参加了八次 CDW。CDW 产生了四个干预原型:检查表、快速参考表、患者/护理人员工作手册和过渡导航员角色。CDW 的产出包括干预措施的描述和成功的衡量标准。2023 年 4 月,20 名 HCP 参加了四个低保真原型会议,展示了四个原型。低保真原型会议的参与者就干预措施的外观、干预措施试图解决的问题以及对干预措施的担忧提供了反馈。
从这项共同设计工作中获得的见解将为 ACEPATH 干预措施的高保真原型测试以及最终的实施和评估提供信息,该干预措施旨在改善接受姑息治疗的患者从医院到家庭的过渡。
有亲身体验的患者和护理人员参加了旨在设计改善从医院到家庭过渡的干预措施的 CDW。他们的直接参与使干预措施与患者和护理人员从医院过渡到家庭时的需求保持一致。此外,在整个项目过程中(从资助申请到手稿撰写),有四名患者/护理人员顾问参与其中,以确保所有阶段都以患者和护理人员为中心。