Exploring the Perceived Acceptability of End-Users for an Innovative Technology-Enabled Model of Palliative Home Care

Background: Older adults constitute the fastest growing population segment globally. The longevity of older adults has contributed to the increased prevalence of chronic conditions and complex health care needs (Canadian Institute for Health Information, 2011). Care required by older adults and at the end-of-life places a significant strain and demand on the Canadian health care system (Fowler & Hammer, 2013). In response to the complex health conditions of older adults at the end-of-life coupled with the challenges in recruiting and retaining healthcare providers in Ontario, Canada, a new and innovative model of palliative home care, eShift, has been developed. The eShift model of palliative home care links unregulated health care providers Care Technicians, providing home care to a remotely-situated directing registered nurse, through a smart phone application using real-time communication and documentation technology. The directing registered nurses monitors and directs appropriate, safe, and effective care provided in collaboration with the care technician in real-time using technology that supports communication about and documentation of care processes, enhancing quality of care delivery for older adults and their family member caregivers. The eShift model has proved to be an effective approach to providing older adults and family member caregivers with quality care. The model optimizes registered nurses with specialized knowledge and skill to meet home care needs; however, there has been little opportunity to explore the perceived acceptability of the end-users (family member caregivers, regulated and unregulated health care providers) of this technology-enabled service delivery model.

Purpose: Having an understanding of end-users’ perceived acceptability is imperative to understand factors that influence the intention to use and uptake and in turn, explain the success and or failure (Duplaga, 2015; Or & Karsh, 2006) of the new and innovative service delivery model.  The overall purpose of this study is to examine and explore the acceptability of informal caregivers, regulated and unregulated in using the eShift model of palliative home care.

Methods: A mixed methods, convergent (parallel) design will be used. Quantitative and qualitative data will be collected simultaneously. Quantitative data will be collected using an adapted Treatment Acceptability and Preference (TAP) questionnaire. Descriptive qualitative methods will be used to explore and understand the perceived acceptability of end-users in using eShift. Qualitative data will be collected through semi-structured interviews. Semi-structured interview questions will explore end-users’ perception of the ease of use, short and long term effectiveness, convenience, benefits and challenges of eShift. 

Potential Results: The eShift model of palliative home care will be perceived to be acceptable by end-users in receiving and providing palliative care within the home care sector. The eShift model of home care will promote a patient-centered approach and meets the needs of older adults and their informal caregivers for end-of-life care within the home care sector. This poster will present preliminary results of the study and provide details of this new model of palliative home care.

Conclusion:  Findings have the potential to inform scale up and spread of the innovative eShift model of home care as broader implementation moves forward. More specifically, the findings will inform nurse researchers, home care and industry partners of the needs, perceived acceptability and preference of the end-users. This in turn, will guide them in modifying and tailoring the model of home care to end-users. It will also transform the delivery of healthcare delivery for community-dwelling older adults living at the end-of-life and their family caregivers.