Preference for Pediatric Telehome Care Support Following Hospitalization: A Report on Preference and Satisfaction

Abstract

The delivery of health care is often segmented into sectors. In Canada, hospital care has traditionally been distinct from community care, and thus the transition of patients across sectors has been challenging. This paper focuses on the systematic development of an integrated model of care for children, for the purpose of smoothing the transition from hospital to home. The new service model uses emerging telecommunications technology to link hospital care providers to patients at home and is termed "telehomecare" (THC). Independent models of THC were developed for three sites across Canada through semistructured interviews and focus groups. Participants included health care providers and administrators from the hospital and community, and patient families. The resulting models were compared using content analysis to determine whether there was a core model of THC that was generalisable across Canada. A core model of THC was identified that includes the use of videoconferencing to enable the integration of hospital- and community-based care to support patients during the initial stages of the transition to home. Each site also articulated unique characteristics in their service model that were related to the nature of their health care delivery system and patient population. This paper describes the core model of transitional care, presents a synopsis of each of the three models, and compares the models. THC provides opportunities to address limitations in the current system and to improve upon equity of access to quality care for children making the transition from hospital to home.

Taking the call-bell home: a qualitative evaluation of Tele-HomeCare for children

“…However, due to the serial nature of the interviews, and the consistency of positive findings and passion of the discourses, we believe that the findings are valid. Furthermore, the findings of this study are consistent with the results of quantitative evaluations of satisfaction with care, and of quality of life from this population, in which a rigorous pre‐post statistical analysis was used (Dick et al . 2004, Young et al.…”

“…In the THC study, the entry of medical technology and caregiver roles into the home was less intrusive and disruptive to family function than the prospect of ongoing hospitalisation, and provided additional security for these families. The overall findings of this study also offer an explanation for the strong preferences families reported for THC and their high levels of satisfaction with the service (mean satisfaction score of 82.8), previously reported by this group (Dick et al . 2004).…”

“…Purposive sampling was used to select a heterogeneous sample of 16 families from a larger intervention trial, involving 63 families who received THC between June 2000 and September 2002 (Dick et al . 2004).…”

Health Information Technology to Facilitate Communication Involving Health Care Providers, Caregivers, and Pediatric Patients: A Scoping Review

“…Although the realities of some contexts can make this ideal impracticable, eight examples of researchers using phased approaches (featuring multiple related studies) to development and evaluation of their interventions were found here [8,10,18,21,25,30,65,66,77,78,92-94,102-105,108,109]. …”

Hospital-to-Home Interventions, Use, and Satisfaction: A Meta-analysis

“…** Both studies in which PCIs were evaluated (1 prepost study that was focused on children with multisystem complex illnesses and 1 prospective cohort study that was focused on the general population of children hospitalized) revealed an association with improved satisfaction. 43,86 CCIs were also associated with improved satisfaction across patient populations, including effective studies in children with chronic illnesses (n = 7), 43,44,48,49,52,53,64 patients in the NICU (n = 2), 78,80 and the general hospitalized population (n = 4). 86,87,89,94 CCIs that were associated with improved satisfaction included assistance with scheduling follow-up care, 43,53,89 in-home visits or follow-up telephone calls, 44,48,49,53,64,86,94 and intensive discharge planning.…”