A new palliative care dashboard for the aged care sector: Why implementation and evaluation matters
A blog post written by Dr Priyanka Vandersman, Research Associate, ELDAC
[This blog is part of a series of blogs commissioned by ELDAC to support aged care health professionals and care providers in providing end of life care. You can find more information on the ELDAC website.]
The global population is ageing rapidly, and a similar trend is being observed in Australia. As Australians continue to live longer and die older, significant increase in demand for aged care services has been observed over the past few decades. Over 70% of older Australians receive some form of aged care service in the last 10 weeks of their lives. [1] This puts enormous demands on the aged care workforce in terms of their ability to provide appropriate end-of-life care. To support aged care workers in planning and providing good quality palliative and end-of-life care, the ELDAC team at Flinders University created an integrated palliative care web platform known as the ELDAC Digital Dashboard (the Dashboard).
The dashboard is an integrated palliative care web platform developed based on the Aged Care Quality Standards and the National Palliative Care Standards. The purpose of the dashboard is to provide clinicians a 'one-stop shop' to graphically view and track all relevant end of life care activities and processes relating to their residents/clients. In line with the Aged Care Quality Standards, the ultimate aim of the dashboard is to build workforce capability around palliative care so older Australians receive person-centred care at the end of their lives.
After finalising the dashboard prototype in 2019, an open call to the Australian aged care IT sector was made, inviting them to integrate the dashboard into their respective clinical data management platforms. The dashboard prototype was built with an intention of direct integration into the ‘back end’ of the aged care data management systems where existing data were to be ‘plugged into’ the dashboard to make it work. As such, the dashboard does not require any direct data entry, and simply relies on data already captured in the electronic resident data management systems used in aged care services. This approach was aimed to minimise duplication of clinical data collection/entry activity, and also to maximise the use of data that is already being collected in one form or other.
The invitation for dashboard integration was taken up by four IT providers/teams, who successfully integrated the dashboard within their IT system. Each provider was offered a small financial support, in addition to the protype codes, and a written implementation manual. But we always knew integration was only ever part of the story. While the Dashboard as a technological product was robust and evidence-based, being available does not guarantee meaningful adoption and use. Evidence suggests that technology implementation in the health/aged care setting is complex and is influenced by a multitude of factors. [2] Therefore, to ensure and evaluate meaningful early use of the dashboard, the ELDAC Digital Dashboard Implementation (EDDI) Study was planned. Reviewed and approved by the Flinders University Ethics committee, this three-month study commenced in August 2020.
Given the approach taken, only services connected to an IT company that had integrated the dashboard were able to participate. These companies sent the EDDI study invitation to their aged care clients (the prospective dashboard users). We had a very positive response from the services who were invited to take part. Currently there are 14 residential aged care homes actively participating in this study. As part of the implementation support, each site is receiving a tailored dashboard training session for their site staff, and one of their staff trained and supported as a dedicated “dashboard champion”. Each site is being asked to use the Dashboard regularly for 8 weeks (trial period) and qualitative data is being collected at the beginning and end of the trial period. Participating sites are being financially reimbursed to compensate for their time and contribution to this study. The study will be completed by end of December 2020.
By the end of the study we hope to understand how a novel technology such as this dashboard gets implemented and used in the aged care sector, and also explore if the dashboard is acceptable and usable for aged care clinicians who provide palliative and end of life care to older Australians. We also anticipate the learnings from this study to be valuable in informing future work on digital technology implementation in the aged care sector.
If you would like to know more about this study, please email the EDDI study coordinator priyanka.vandersman@flinders.edu.au. Find out more information about the Digital Dashboard and try it out for yourself by using the dashboard prototype demo on the ELDAC website.
References
- Australian Institute of Health and Welfare. Use of aged care services before death. Canberra: AIHW; 2015.
- Cresswell KM, Bates DW, Sheikh A. Ten key considerations for the successful implementation and adoption of large-scale health information technology. J Am Med Inform Assoc. 2013 Jun;20(e1):e9-e13. doi: 10.1136/amiajnl-2013-001684. Epub 2013 Apr 18.
Dr Priyanka Vandersman, Research Associate at ELDAC