NDLI: Mind the gap: analysis of two pilot projects of a home telehealth service for persons with complex conditions in a Swedish hospital

Content Provider	Springer Nature : BioMed Central
Author	Sacchi, Carla Andersson, Karolina Roczniewska, Marta Luckhaus, Jamie Linnéa Malmqvist, Moa Rodmalm, Lars Peter Lodin, Karin Mosson, Rebecca Danapfel, Petra Wannheden, Carolina Mazzocato, Pamela
Abstract	Background Developing and implementing home telehealth (HTH) services for patients with chronic conditions is a challenge. HTH services provide continuous and integrated care to patients, but very often pilot projects face non-adoption and abandonment issues. Change processes in healthcare are often complex and require learning to adapt to non-linear and unpredictable events. Complexity science can thus provide a complementary view to the predominant Quality Improvement (QI) approach in healthcare. In this study of two pilot projects in a Swedish hospital, we explore how a theory-driven approach can be used (a) to support the development of a self-monitoring HTH service in hospital care and (b) to evaluate staff and patients’ experiences from early adoption. Methods To plan and evaluate the service for the recipients (i.e., patients and healthcare providers), we used the Plan-Do-Study-Act (PDSA) tool in combination with two complexity-informed frameworks: the Non-adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework, and the joint Complexity Assessment Tool (CAT). The theory-informed development process led to two pilot projects of an HTH service for patients with heart failure and COVID-19. We collected data from multiple sources (project documents, a survey on readiness for change among staff, and semi-structured interviews with patients and staff) and analyzed the data using descriptive statistics and qualitative content analysis with a deductive approach. Results Patients and staff perceived the services as valuable as they enabled rapid feedback, and improved communication and collaboration between patients and healthcare providers. Yet, despite the extensive development efforts, there was a perceived gap between how individuals valued the service and the capacity of adopters, the organization, and the wider system to effectively integrate these services into routine care. Conclusions The combined use of PDSA, NASSS, and CAT can support the development and evaluation of HTH services that are perceived as valuable by individual patients and staff. For successful adoption, the value for individuals must be supported by organizational efforts to learn how to integrate new routines and tasks into clinical practice and daily life, and how to coordinate multiple providers within and outside the hospital walls.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-023-09409-4.pdf
Ending Page	15
Page Count	15
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-023-09409-4
Journal	BMC Health Services Research
Issue Number	1
Volume Number	23
Language	English
Publisher	BioMed Central
Publisher Date	2023-05-09
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Complexity Quality improvement Innovation Telehealth Heart failure COVID-19
Content Type	Text
Resource Type	Article
Subject	Health Policy

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Impact of the COVID-19 pandemic on hospital-based heart failure care in New South Wales, Australia: a linked data cohort study

Establishing a centralised telehealth service increases telehealth activity at a tertiary hospital

Health workforce perceptions on telehealth augmentation opportunities

Implementations and strategies of telehealth during COVID-19 outbreak: a systematic review

Examining innovation in hospital units: a complex adaptive systems approach

Rural patient and provider perceptions of telehealth implemented during the COVID-19 pandemic

Socioeconomic factors associated with use of telehealth services in outpatient care settings during the COVID-19

Using Telehealth to Reduce All-Cause 30-Day Hospital Readmissions among Heart Failure Patients Receiving Skilled Home Health Services.

Improvement of primary care for patients with chronic heart failure: a pilot study

Mind the gap: analysis of two pilot projects of a home telehealth service for persons with complex conditions in a Swedish hospital

Similar Documents

Impact of the COVID-19 pandemic on hospital-based heart failure care in New South Wales, Australia: a linked data cohort study

Establishing a centralised telehealth service increases telehealth activity at a tertiary hospital

Health workforce perceptions on telehealth augmentation opportunities

Implementations and strategies of telehealth during COVID-19 outbreak: a systematic review

Examining innovation in hospital units: a complex adaptive systems approach

Rural patient and provider perceptions of telehealth implemented during the COVID-19 pandemic

Socioeconomic factors associated with use of telehealth services in outpatient care settings during the COVID-19

Using Telehealth to Reduce All-Cause 30-Day Hospital Readmissions among Heart Failure Patients Receiving Skilled Home Health Services.

Improvement of primary care for patients with chronic heart failure: a pilot study

Mind the gap: analysis of two pilot projects of a home telehealth service for persons with complex conditions in a Swedish hospital