Abstract
BackgroundVideoconferencing has been proposed as a way of improving access to healthcare for older adults in care homes. Despite this, effective uptake of videoconferencing remains varied. This study evaluates a videoconferencing service for care home staff seeking support from healthcare professionals for the care of residents. The aim was to explore factors affecting the uptake and sustainability of videoconferencing in care homes, to establish what works for whom, in which circumstances and respects. The findings informed recommendations for commissioners and strategic managers on how best to implement videoconferencing for remote healthcare provision in care homes for older adults.MethodsRealist evaluation was used to develop, refine and test theories around the uptake and maintenance of videoconferencing in three care homes across Yorkshire and the Humber, England. The care homes were selected using maximum variation sampling regarding the extent to which they used videoconferencing. A developmental inquiry framework and realist interviews were used to identify Context, Mechanism and Outcome Configurations (CMOCs) regarding uptake and sustainability of the service. Participants included care home residents (aged > 65) and staff, relatives and strategic managers of care home chains. The interviews were an iterative process conducted alongside data analysis. Transcripts of audio recordings were entered into NVIVO 12, initially coded into themes, then hypotheses developed, refined and tested.ResultsOutcomes were generated in relation to two main contextual factors, these were: (1) communication culture in the home and (2) the prior knowledge and experience that staff have of videoconferencing. The key facilitators identified were aspects of leadership, social links within the home and psychological safety which promoted shared learning and confidence in using the technology.ConclusionsVideoconferencing is a valuable tool, but successful implementation and sustainability are dependent on care home culture and staff training to promote confidence through positive and supported experiences.
Highlights
Videoconferencing has been proposed as a way of improving access to healthcare for older adults in care homes
This paper explores key aspects of the care home context that influence the uptake and sustainability of videoconferencing for remote healthcare provision
Care home one This care home had been trialling videoconferencing for 11 months at the time of this fieldwork. This service has since been withdrawn by the Clinical Commissioning Groups (CCGs) as the trial found that the introduction of videoconferencing at pilot sites had increased the number of hospital admissions
Summary
Videoconferencing has been proposed as a way of improving access to healthcare for older adults in care homes. This study evaluates a videoconferencing service for care home staff seeking support from healthcare professionals for the care of residents. Rationale for evaluation The number of older adults in the UK is increasing [1], resulting in rising demand in the care home sector [2]. This grow in demand, along with funding cuts makes delivering healthcare to care home residents challenging [3].
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