Our research found that intravenous (IV) therapy, oxygen therapy, parenteral nutrition (PN), and peritoneal dialysis (PD) are widespread home-care technologies in Quebec. We also learned that the successful use of these high-tech innovations within the home depends on two critical factors:
High-quality information about how technologies function and how they should be used and maintained
Research-driven staff training that addresses technical and clinical issues as well as the ethical and psychosocial aspects of delivering high-tech care in patients’ homes
High-quality information
Currently, there appears to be unevenness in both the scientific basis and scope of the information home care providers have access to and are transmitting to patients and caregivers.
In Quebec, primary care organizations (CSSSs) rely heavily on three main sources for information about high-tech home care devices:
Written material provided by manufacturers (39%: “very/extremely often”)
Hospitals (34%: “very/extremely often”)
Professional bodies (25%: “very/extremely often”)
A majority of respondents (64%) to our survey of CSSSs told us they used scientific journals “occasionally,” while the least-often considered sources were the Quebec Health Technology Assessment Agency (AETMIS) and Web sites (43% and 62% respectively: “never”). These latter findings likely reflect the fact that health care providers are unable to access easily the information they need in those sources.
Two types of training stood out as the most frequent amongst CSSS respondents:
Peer-to-peer staff training (29%: “very/extremely often”)
Training by vendors and manufacturers (21%: “very/extremely often”)
A majority (63%) of CSSSs also told us they “occasionally” arranged for hospitals to train their staff. Biomedical engineering firms and other CSSSs were the least-frequent training sources (49% and 46% respectively: “never”).
Recommendations
It is often claimed that the growing availability of technology will increase the provision of home care. Our research, though, revealed considerable uncertainty about the scientific basis and scope of the information home care providers have access to and are, in turn, transmitting to patients and caregivers. We thus offer five recommendations:
Knowing that vendors and manufacturers are active in staff training, it’s vital to examine the level and quality of training home care providers require and receive.
Primary care organizations’ sources of information and staff training should be supplemented by material based on scientific research and professional standards.
Rigorous educational programs detailing how to use technology in patients’ homes should be developed. Universities, for example, could design and deliver continuing education opportunities in the area.
A strong staff training policy should be created. Such training would be based on research evidence about technical and clinical issues and encompass ethical and psychosocial considerations.
At the provincial level, formal, regularized re-evaluation should support the development and use of staff training packages.
Based on :Lehoux, P., R. Pineault, L. Richard, J. St-Arnaud, S. Law, & H. Rosendal. (2003)
Adapted by :Morgan Holmes, Ph.D.
REFERENCES
Lehoux, P., R. Pineault, L. Richard, J. St-Arnaud, S. Law, & H. Rosendal. (2003). Issues in quality of high-tech home care: Sources of information and staff training in Quebec primary care organizations and relationships with hospitals. International Journal of Health Care Quality Assurance 16.1: 37-46.
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