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  • Integrating a Quality of Life Assessment and Practice Support System (QPSS) in homecare services for older adults with life-limiting illness and their families

Integrating a Quality of Life Assessment and Practice Support System (QPSS) in homecare services for older adults with life-limiting illness and their families

Older adults who have advancing life-limiting illnesses and who are receiving health care at home often have complex problems that affect their overall quality of life (QOL). Progress has been made in managing symptoms, but health care professionals (HCPs) may overlook other issues that impact the QOL of patients and their family caregivers. Routinely assessing patient and family QOL can provide HCPs with more information about concerns and experiences with health care delivery, thereby better allowing HCPs to address patient and family needs

This project aims to improve home care service delivery and QOL of older adults who have life-limiting illnesses and their family caregivers. Specifically, our team will study the integration of an innovative computer tablet-based Quality of Life Assessment and Practice Support System (QPSS) in home health care, and evaluate its usefulness as a comprehensive system to assess and monitor the QOL of patients and family caregivers so that health care needs can be addressed appropriately. Patients, family caregivers, and clinicians will all routinely use the QPSS during home visits to assess symptoms; physical, psychological, social and existential/spiritual well-being; and experiences with the care provided. Administrators and decision-makers can use the information to improve care throughout the health care system.

This project involves three stages:

  1. Local adaptation stage:
    • Focus groups and interviews will collect data from each of the 9 home care service sites so that the QPSS can be adapted and integrated into each local context
    • This stage will also include baseline data collection to measure patient and family caregiver QOL and care experiences, as well as data associated with the cost of implementation
  2. Evaluation stage:
    • A randomized controlled trial (RCT) will be conducted to evaluate the impact of the QPSS on the QOL and care experiences of patients and family caregivers
    • An economic evaluation of continued use of the QPSS in home care
  3. Sustainability stage:
    • Do results warrant sustained and widespread implementation of the QPSS in homecare?
    • How can QPSS implementation be scaled up?
    • How can the QPSS be integrated with other health information systems?

Research Objectives:

  1. To examine the efficacy of the QPSS in home care for older adults who have advancing life-limiting illnesses,
  2. To evaluate the cost consequences of implementing the QPSS in home care,
  3. To understand the process of implementing the QPSS in home care, and
  4. To examine how integration of the QPSS with health information systems will meet the needs of administrators for quality improvement and accreditation.

 

Core Leadership Team
Principal Investigator
Richard Sawatzky, Associate Professor, School of Nursing, Trinity Western University

Co-Principal Investigators
Robin Cohen, Professor, Departments of Oncology and Medicine, McGill University
Kara Schick-Makaroff, Assistant Professor, Faculty of Nursing, University of Alberta
Kelli Stajduhar, Professor, Institute on Aging and Lifelong Health and School of Nursing, University of Victoria

Principal Knowledge User
Neil Hilliard, Program Medical Director, End of Life Care, Fraser Health Authority

Decision makers
Lisa Zetes-Zanatta, Executive Director New Westminster Community Health Services, End of Life Care, Home Health, Fraser Health Authority

Patient and Family Engagement Panel
Shelly Cory, Executive Director, Canadian Virtual Hospice
Mary Luk, Family Caregiver
Alies Maybee, Patient/Family Caregiver
Joyce Resin, Citizen Engagement Committee Chair, Canadian Frailty Network
Geoff Cowman, Chair, CARP (Richmond/Delta Chapter)
Barb MacLean, Executive Director, Family Caregivers of BC

Clinician and Healthcare Administration Panel
Clinicians
Susan Brown, Clinical Nurse Specialist, Fraser Health Authority
Janet Carlson, Nurse Practitioner, Alberta Health Services
Jenny Haskins, Nurse Practitioner, Fraser Health Authority
Melissa Kundert, Nurse Practitioner, Fraser Health Authority
Barbara McLeod, Clinical Nurse Specialist, Fraser Health Authority
Della Roberts, Clinical Nurse Specialist, Island Health
Jean Warneboldt, Palliative Care Consultant Physician, Fraser Health Authority

Healthcare Administration
Lena Cuthbertson, Provincial Director, British Columbia Ministry of Health
Jill Gerke, Regional Manager, Island Health Authority
Cori Paul, Advanced Practice Manager, Alberta Health Services
Carolyn Tayler, Investigator, Initiative for a Palliative Approach in Nursing: Evidence and Leadership
Daphne Williscroft, Interim Director, Fraser Health Authority
Sharon Baxter, Executive Director, Canadian Hospice Palliative Care Association

Health Technology Panel
Bruce Forde, CEO, Cambian Business Services
Herbert H. Tsang, Associate Professor, Department of Computing Science and Mathematics, Trinity Western University
James Voth, Founder and Director, Intogrey Research and Development Inc.

Researcher Panel
Canadian researchers:
Joan Bottorff, Professor, School of Nursing, University of British Columbia
Stirling Bryan, Professor, School of Population and Public Health, University of British Columbia
Peter Dodek, Professor, Critical Care Medicine, University of British Columbia
Kimberly Fraser, Associate Professor, Faculty of Nursing, University of Alberta
Anne Gadermann, Post-doctoral fellow, Centre for Health Evaluation and Outcomes Sciences,
St. Paul’s Hospital, University of British Columbia
Esther Laforest, Doctoral nursing student, Ingram School of Nursing, McGill University
Maria Parrilla Lopez, Associate Director Strategy for Patient-oriented Research (SPOR) Methods
Platform, Alberta CIHR Strategy for Patient-oriented Research
Sheryl Reimer-Kirkham, Professor, School of Nursing, Trinity Western University
Pamela Ratner, Professor, School of Nursing, University of British Columbia
Lara Russell, Post-doctoral fellow, School of Nursing, University of Victoria
Maria Santana, Assistant Professor, University of Calgary
David Whitehurst, Assistant Professor, Faculty of Health Sciences, Simon Fraser University

International researchers:
Todd Edwards, Research Assistant Professor, Department of Health Services, University of Washington
Gail Ewing, Senior Research Associate, Cambridge University
Gunn Grande, Professor, University of Manchester
Joakim Öhlén, Professor,
University of Gothenburg

Project Contact:
Joyce Lee, This email address is being protected from spambots. You need JavaScript enabled to view it.

Timeline:  Commenced October, 2015.  Expected end date September, 2019.

Status: In progress

Funding: Canadian Institutes of Health Research

cihr logo big e

In-Kind Funding Provided by Project Partners:
Cambian Business Services Inc.
Intogrey Research and Development Inc.
Fraser Health

Support Provided by:
Geoff Cowman, CARP (Richmond/Delta)
Barb MacLean, Family Caregivers of British Columbia
Canadian Hospice Palliative Care Association
The Canadian Virtual Hospice
Mary Luk, Alies Maybee, Catherine Yau (patient/family caregiver representatives)

 

Integrating a Quality of Life Assessment and Practice Support System (QPSS) in homecare services for older adults with life-limiting illness and their families

 

Older adults who have advancing life-limiting illnesses and who are receiving health care at home often have complex problems that affect their overall quality of life (QOL). Progress has been made in managing symptoms, but health care professionals (HCPs) may overlook other issues that impact the QOL of patients and their family caregivers. Routinely assessing patient and family QOL can provide HCPs with more information about concerns and experiences with health care delivery, thereby better allowing HCPs to address patient and family needs

 

This project aims to improve home care service delivery and QOL of older adults who have life-limiting illnesses and their family caregivers. Specifically, our team will study the integration of an innovative computer tablet-based Quality of Life Assessment and Practice Support System (QPSS) in home health care, and evaluate its usefulness as a comprehensive system to assess and monitor the QOL of patients and family caregivers so that health care needs can be addressed appropriately. Patients, family caregivers, and clinicians will all routinely use the QPSS during home visits to assess symptoms; physical, psychological, social and existential/spiritual well-being; and experiences with the care provided. Administrators and decision-makers can use the information to improve care throughout the health care system.

 

Research Objectives:

1.       To examine the efficacy of the QPSS in home care for older adults who have advancing life-limiting illnesses,

2.       To evaluate the cost consequences of implementing the QPSS in home care,

3.       To understand the process of implementing the QPSS in home care, and

4.       To examine how integration of the QPSS with health information systems will meet the needs of administrators for quality improvement and accreditation.

 

This project involves three stages:

1.       Local adaptation stage:

a.       Focus groups and interviews will collect data from each of the 9 home care service sites so that the QPSS can be adapted and integrated into to each local context

b.      This stage will also include baseline data collection to measure patient and family caregiver QOL and care experiences, as well as data associated with the cost of implementation

2.       Evaluation stage:

a.       A randomized controlled trial (RCT) will be conducted to evaluate the impact of the QPSS on the QOL and care experiences of patients and family caregivers

b.      An economic evaluation of continued use of the QPSS in home care

3.       Sustainability stage:

a.       Do results warrant sustained and widespread implementation of the QPSS in homecare?

b.      How can QPSS implementation be scaled up?

c.       How can the QPSS be integrated with other health information systems?

 

Core Leadership Team

Principal Investigator

Dr. Richard Sawatzky, Associate Professor, School of Nursing, Trinity Western University

 

Co-Principal Investigators

Dr. Robin Cohen, Professor, Departments of Oncology and Medicine, McGill University

Dr. Kara Schick-Makaroff, Assistant Professor, Faculty of Nursing, University of Alberta

Dr. Kelli Stajduhar, Professor, Centre on Aging and School of Nursing, University of Victoria

 

Principal Knowledge User

Dr. Neil Hilliard, Program Medical Director, End of Life Care, Fraser Health Authority

 

Decision makers

Ms. Lisa Zetes-Zanatta, Executive Director New Westminster Community Health Services, End of Life Care, Home Health, Fraser Health Authority

 

Patient and Family Engagement Panel

Ms. Shelly Cory, Executive Director, Virtual Hospice Executive Team

Ms. Mary Luk, Family Caregiver

Ms. Alies Maybee, Patient/Family Caregiver

Ms. Joyce Resin, Citizen Engagement Committee Chair, Technology Evaluation in the Elderly Network

 

Clinician and Healthcare Administration Panel

Clinicians

Ms. Susan Brown, Clinical Nurse Specialist, Fraser Health Authority

Ms. Janet Carlson, Nurse Practitioner, Alberta Health Services

Ms. Jenny Haskins, Nurse Practitioner, Fraser Health Authority

Ms. Melissa Kundert, Nurse Practitioner, Fraser Health Authority

Mrs. Barbara McLeod, Clinical Nurse Specialist, Fraser Health Authority

Ms. Della Roberts, Clinical Nurse Specialist, Island Health

Dr. Jean Warneboldt, Palliative Care Consultant Physician, Fraser Health Authority

 

Healthcare Administration

Ms. Lena Cuthbertson, Provincial Director, British Columbia Ministry of Health

Mrs. Jill Gerke, Regional Manager, Island Health Authority

Ms. Cori Paul, Advanced Practice Manager, Alberta Health Services

Ms. Carolyn Tayler, Investigator, Initiative for a Palliative Approach in Nursing: Evidence and Leadership

Ms. Daphne Williscroft, Interim Director, Fraser Health Authority

Mrs. Sharon Baxter, Executive Director, Canadian Hospice Palliative Care Association

 

Health Technology Panel

Dr. Bruce Forde, CEO, Cambian Business Services

Dr. Herbert H. Tsang, Associate Professor, Department of Computing Science and Mathematics, Trinity Western University

Mr. James Voth, Founder and Director, Intogrey Research and Development Inc.

 

Researcher Panel

Canadian researchers:

Dr. Joan Bottorff, Professor, School of Nursing, University of British Columbia

Dr. Stirling Bryan, Professor, School of Population and Public Health, University of British Columbia

Dr. Peter Dodek, Professor, Critical Care Medicine, University of British Columbia

Dr. Kimberly Fraser, Associate Professor, Faculty of Nursing, University of Alberta

Dr. Anne Gadermann, Post-doctoral fellow, Centre for Health Evaluation and Outcomes Sciences,

St. Paul’s Hospital, University of British Columbia

Ms. Esther Laforest, Doctoral nursing student, Ingram School of Nursing, McGill University

Dr. Maria Parrilla Lopez, Associate Director Strategy for Patient-oriented Research (SPOR) Methods

Platform, Alberta CIHR Strategy for Patient-oriented Research

Dr. Sheryl Reimer-Kirkham, Professor, School of Nursing, Trinity Western University

Dr. Pamela Ratner, Professor, School of Nursing, University of British Columbia

Dr. Lara Russell, Post-doctoral fellow, School of Nursing, University of Victoria

Dr. Maria Santana, Assistant Professor, University of Calgary

Dr. David Whitehurst, Assistant Professor, Faculty of Health Sciences, Simon Fraser University

 

International researchers:

Dr. Todd Edwards, Research Assistant Professor, Department of Health Services, University of Washington

Dr. Gail Ewing, Senior Research Associate, Cambridge University

Professor Gunn Grande, University of Manchester

Professor Joakim Öhlén, University of Gothenburg

 

Project Contact:

Joyce Lee, This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Timeline:  Commenced October, 2015.  Expected end date September, 2019.

 

Funding: CIHR [with CIHR logo]

 

Status: In progress

 

 

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