Relational use of an electronic quality of life and practice support system in hospital palliative consult care: a pilot study

Krawczyk, M. and Sawatzky, R. (2019) Relational use of an electronic quality of life and practice support system in hospital palliative consult care: a pilot study. Palliative and Supportive Care, 17(2), pp. 208-213. (doi:10.1017/S1478951518000020) (PMID:29516852)

Krawczyk, M. and Sawatzky, R. (2019) Relational use of an electronic quality of life and practice support system in hospital palliative consult care: a pilot study. Palliative and Supportive Care, 17(2), pp. 208-213. (doi:10.1017/S1478951518000020) (PMID:29516852)

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Abstract

Objectives: This study is part of an overarching research initiative on the development and integration of an electronic Quality of Life and Practice Support System (QPSS) that uses patient-reported outcome and experience measures in clinical practice. The current study focused on palliative nurse consultants trialing the QPSS with older hospitalized adults receiving acute care. The primary aim of the study was to better understand consultants’ and patients’ experiences and perspectives of use. Method: The project involved two nurse specialists within a larger palliative outreach consult team (POCT) and consenting older adult patients (age 55+) in a large tertiary acute care hospital in western Canada. User-centered design of the QPSS was informed by three focus groups with the entire POCT team, and implementation was evaluated by direct observation as well as interviews with the POCT nurses and three patients. Thematic analysis of interviews and field notes was informed by theoretical perspectives from social sciences. Result: Over 9 weeks, the POCT nurses used the QPSS at least once with 20 patients, for a total of 47 administrations. The nurses most often assisted patients in using the QPSS. Participants referenced three primary benefits of relational use: enhanced communication, strengthened therapeutic relations, and cocreation of new insights about quality of life and care experiences. The nurses also reported increased visibility of quality of life concerns and positive development as relational care providers. Significance of results: Participants expressed that QPSS use positively influenced relations of care and enhanced practices consistent with person-centered care. Results also indicate that electronic assessment systems may, in some instances, function as actor-objects enabling new knowledge and relations of care rather than merely as a neutral technological platform. This is the first study to examine hospital palliative consult clinicians’ use of a tablet-based system for routine collection of patient-reported outcome and experience measures.

Item Type:Articles
Additional Information:The research was, in part, possible because of fellowship funding for the first author from the Canadian Frailty Network and Trinity Western University, and funds from the Canada Research Chairs Program. We also acknowledge, with gratitude, the in-kind contribution of our industry partner James Voth of Intogrey Research and Development Inc.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Krawczyk, Dr Marian
Authors: Krawczyk, M., and Sawatzky, R.
College/School:College of Social Sciences > School of Interdisciplinary Studies
Journal Name:Palliative and Supportive Care
Publisher:Cambridge University Press
ISSN:1478-9515
ISSN (Online):1478-9523
Published Online:08 March 2018
Copyright Holders:Copyright © 2018 Cambridge University Press
First Published:First published in Palliative and Supportive Care 17(2): 208-213
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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