Health Care Staff’s Experiences of Engagement When Introducing a Digital Decision Support System for Wound Management: Qualitative Study

Abstract

Background eHealth solutions such as digital decision support systems (DDSSs) have the potential to assist collaboration between health care staff to improve matters for specific patient groups. Patients with hard-to-heal ulcers have long healing times because of a lack of guidelines for structured diagnosis, treatment, and follow-up. Multidisciplinary collaboration in wound management teams is essential. A DDSS could offer a way of aiding improvement within wound management. The introduction of eHealth solutions into health care is complicated, and the engagement of the staff seems crucial. Factors influencing and affecting engagement need to be understood and considered for the introduction of a DDSS to succeed. Objective This study aims to describe health care staff’s experiences of engagement and barriers to and influencers of engagement when introducing a DDSS for wound management. Methods This study uses a qualitative approach. Interviews were conducted with 11 health care staff within primary (n=4), community (n=6), and specialist (n=1) care during the start-up of the introduction of a DDSS for wound management. The interviews focused on the staff’s experiences of engagement. Content analysis by Burnard was used in the data analysis process. Results A total of 4 categories emerged describing the participants’ experiences of engagement: a personal liaison, a professional commitment, an extended togetherness, and an awareness and understanding of the circumstances. Conclusions This study identifies barriers to and influencers of engagement, reinforcing that staff experience engagement through feeling a personal liaison and a professional commitment to make things better for their patients. In addition, engagement is nourished by sharing with coworkers and by active support and understanding from leadership.

Still engaged – healthcare staff’s engagement when introducing a new eHealth solution for wound management: a qualitative study

“…A shared understanding of the potential usefulness of the eHealth solution in wound management and engagement among others in the group, including stimulating and satisfactory leadership, were described as important for engagement over time. Collegial and organisational support being described as valuable in building positive experiences in implementation of eHealth solutions is supported by experiences from the introduction of the DDSS [ 17 ] and findings from a review conducted by Konttila and colleagues [ 27 ]. Kahn [ 28 ] also suggested that social connections, such as work interactions and interpersonal relationships, are crucial sources of meaning and that work climates characterised by openness and support help people dare to ‘risk’ being engaged.…”

“…The DDSS is intended for use by multiple healthcare professionals, supporting them with structured processes for clinical teams to improve wound management: diagnosing and treating ulcers and reducing healing time and patient suffering. For more information, see previous publications [ 17 ]. Dermicus Wound is CE-certified as a Medical Device, Class I (D3.0–112,015), and compatible with iPhone devices, using a standard touchscreen user interface and camera.…”

“…One commonly used example of an eHealth solution is the digital decision support system (DDSS), which serves to support medical decisions and education in everyday clinical practice [ 16 ]. Such systems are getting increased attention because they can promote collaboration and cooperation between different healthcare professions [ 17 ], something that is particularly important for patients with hard-to-heal ulcers. A DDSS can be used in home care by a nurse or nurse assistant visiting the patient, to enable provision of expert advice from wound management teams in primary or specialist care without the patient being obliged to travel to a clinic.…”

“…Attitudes connected to engagement as a cognitive dimension and clinical engagement behaviour to develop patient safety and quality of care are also mentioned in the literature [ 21 ]. Furthermore, engagement at the personal level depends on active support from the surroundings and individual experiences such as relevance, interest and enjoyment [ 17 ].…”

“…Evaluation of staff engagement in using a DDSS has previously been described in the early stage when the solution was new and unfamiliar to the users (cf. [ 17 ]). However, it is also essential to understand the engagement process in the long term, as regards sustainability, staff wellbeing and efficiency.…”