A co‐designed health information system implementation into residential aged care: A mixed‐method evaluation

• Published in: Journal of nursing scholarship 2023-03, Vol.55 (2), p.521-535
• Main Authors: Bail, Kasia, Merrick, Eamon, Gibson, Diane, Hind, Alicia, Strickland, Karen, Redley, Bernice
• Format: Article
• Language: English
• Subjects: Access to information; Accreditation; Action research; Aged; Australia; Co-design; Consultants; Data; Data collection; Documentation; Efficiency; Elder care; Electronic health records; Focus Groups; geriatrics; Health informatics; Health information; Health Information Systems; Health status; Homes for the Aged; Humans; Implementation; informatics; Information systems; Information technology; mixed methods; Mixed methods research; Nurse led services; Nurses; Nursing care; Nursing Homes; Participatory action research; Participatory research; Residential care; Supervisor-Subordinate interactions
• ISSN: 1527-6546; 1547-5069
• DOI: 10.1111/jnu.12840

Introduction Internationally, the adoption of technology into residential aged care settings has been slow and fraught with multiple challenges for residents, staff and service providers. The aim of this study was to evaluate the acceptability, efficiency, and quality of health information system implementation into aged care. Methods Three‐stage, mixed‐methods participatory action research, concurrent with the natural experiment of a co‐designed health information system implementation into a 169‐bed aged care home in Australia. Data were collected pre‐, during, and post implementation between 2019 and 2021. Qualitative data included focus groups, interviews, and observations. Quantitative data included work observations, pedometers, record audits, incident reports and staff and resident surveys. There were 162 participants composed of 65 aged care residents, 90 staff, and 7 managers/consultants. Results Improved work efficiency included reduced staff time searching for information (6%); reduced nurse time on documentation (20.4% to 6.4%), and 25% less steps. Documentation improvement included resident assessments (68% to 96%); resident‐focused goals (56% to 88%) and evaluations (31% to 88%). The staff reported being better equipped to manage the ‘delicacies of dignity’. Conclusion Implementation of a health information system into a residential aged care facility was associated with improved resident‐focused care and staff efficiency. Clinical relevance Technology can support nurses and care staff to spend more time with residents in residential aged care homes, improve the quality of resident care, and assist meeting regulatory reporting requirements. Flexible and tailored co‐design strategies can enhance both effectiveness and success of technology implementation into residential aged care.