Implementation Science Addresses Training and Technology Needs of Health Care Workers Caring for Adults With HF

Aug 04, 2020
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Authors:
Sterling MR, Dell N, Tseng E, et al.
Citation:
Home care workers caring for adults with heart failure need better access to training and technology: A role for implementation science. J Clin Transl Sci 2020;4:224-8.
Summary By:
Katherine M Reeder, PhD, RN

Quick Takes

  • Health care workers who provide care in patients’ homes need access to disease-specific electronic resources using technologies other than personal cell phones.
  • Paperless care plans that can be updated and health care information transmitted in real time for clinical treatment decision-making are needed.
  • Training that specifically addresses important aspects of care for patients with heart failure (HF), including enhanced technologies and protocols for timely reporting and health care decision-making communication, are needed to enhance visibility and better integrate the work of health care workers as members of health care teams.

Study Questions:

What is the role of technology among health care workers caring for patients with HF and what are the opportunities for identifying how technology could improve home health care delivery and better leverage the role of health care workers in the care team?

Methods:

A qualitative design was employed using purposeful sampling of key stakeholders of the role of technology among health care workers in HF. Interviews and focus groups were conducted with health care workers, nurses, home care agency leaders and staff, care coordinators, unpaid family (informal) caregivers, patients living with HF, physicians, and social workers. Interviews were recorded and transcribed verbatim. Narratives were coded and analyzed thematically.

Results:

The sample of 38 key stakeholders were all women whose ages ranged from 22 to 69 years and who had an average of 13 years of caregiving experience. Interviews ranged from 30 to 60 minutes in length. The following 4 major themes emerged from the interview data:

  1. Communication is critical but problematic.
  2. Existing technology is outdated and ineffective.
  3. Health care workers have limited access to disease-specific electronic resources.
  4. Technology can be leveraged to improve health care workers’ experience and health care delivery.

Conclusions:

Despite being integral to home health care delivery for adults living with HF, investigators found that health care workers lack training in HF care and are poorly integrated into the medical team, a situation that is worsened by ineffective communication practices. Although health care workers are required to use various technologies in caring for patients, the majority of tools and systems they use are outdated and do not meet current needs, further exacerbating communication challenges.

Perspective:

Home health care workers spend more time with patients than any other health care team member, yet health care workers are virtually invisible members of the health care team. This systematic lack of awareness of the role of health care workers can perpetuate the challenges encountered by home health care workers (i.e., ineffective communication, insufficient HF training, and insufficient and outdated technologies) in their daily work with patients with HF. Opportunities for enhancing technology and communication were identified for improving health care workers’ ability to care for adults with HF in the patients’ homes.

Clinical Topics: Cardiovascular Care Team, Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Technology, Wireless Technology, Patient Care Team, Caregivers, Home Health Aides, Home Care Services, Delivery of Health Care, Patient Care, Heart Failure


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