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

Abstract

Tele-HomeCare (THC) delivers health care at home using telephone technologies. A THC service was developed as an adjunct to existing hospital and community care systems. It connected healthcare providers to children and families at home, during the initial transition from hospital to home, using video-conferencing phones and remote vital signs monitors. The goal was to support the transition from hospital to home, for children with subacute healthcare needs. This paper reports the qualitative evaluation of THC and describes the experiences of families supported by THC. A total of 16 mothers, four fathers and two adolescents from 16 families participated in a series of interviews conducted before, during and after THC. The interviews focused on the impact of THC on the children, on the families, and on their overall healthcare experience. Analysis of their accounts identified three subthemes: the stable child, a sense of security, and the healthcare-proficient parent. These subthemes were consistent across all time points and participants. Together they contributed to the overall effect of THC: the timely reunification of the family at home. THC was consistently reported to be an important resource that supported children and families during the transition from hospital to home. The benefits to children and families observed in this study may have also been a consequence of returning to their home environment, since THC allowed these children to be discharged home at a much earlier period. However, our findings are consistent with previous reports of the benefits of THC. Thus, THC is a successful method of healthcare service delivery that enables a safe return home with professional support provided remotely.

A randomised trial of a remote home support programme for infants with major congenital heart disease

“…It also facilitates resolution of more minor problems which cause considerable parental anxiety, and when presented to the non-specialist in primary and secondary care settings, may result in hospital admission. There are several important advantages to keeping these vulnerable patients at home: avoiding exposure to infections in crowded waiting areas and hospital wards, and minimising family disruption, particularly, associated with hospitalising a child 21. Parents feel confident that their baby has been clinically assessed by a health professional familiar with the anatomy, physiology and ongoing health issues particular to their baby.…”

Experience with videoconferencing between a neonatal unit and the families' home from the perspective of certified paediatric nurses

“…19 A study in children with subacute health-care needs showed that video played an important role during the early stages at home, enabling parents to become confident in caring for their child, and helping them to establish a strong rapport with the health-care providers. 20 Although videoconferencing can give the feeling of meeting the family, it cannot totally replace face-to-face visits. 21 It is important to bear in mind that if telemedicine was used as a replacement for standard care, instead of being used just as an adjunct, then the positive results might not be replicated.…”

Connecting Hospitalized Patients with Their Families: Case Series and Commentary

“…The technology also provided family members from other states to see the baby, further connecting the family [26]. Home videoconferencing has also been shown to be successful in the postoperative management of children recently discharged with complex congenital heart disease [15, 27] as well as other complex diagnoses [15, 28–30] with a high degree of parent satisfaction [31]. …”