Home care workers caring for adults with heart failure need better access to training and technology: A role for implementation science.

Madeline R Sterling,Fabian Okeke,Jonathan N Tobin,Jacklyn Cho,Benedetta Piantella,Nicola Dell,Emily Tseng

doi:10.1017/cts.2020.36

Abstract

Although highly involved in heart failure (HF) patients' care, home care workers (HCWs) lack HF training and are poorly integrated into the healthcare team. For its potential to address these challenges, we examined the role of technology among HCWs caring for HF patients. We conducted 38 interviews with key stakeholders. Overall, four themes emerged. Participants reported that technology is critical for HF care, but existing systems are outdated and ineffective. HCWs also have limited access to electronic resources. Technology, training, and principles of implementation science can be leveraged to improve HCWs' experience in caring for HF patients and home healthcare delivery.

Highlights

Home care workers (HCWs), which include home health and personal care aides, represent one of the fastest growing sectors of the healthcare industry and US economy [1]
HCWs, agency staff and leaders, and care coordinators worked for nine different home care agencies in NYC
Despite being integral to home healthcare delivery, we found that HCWs lack heart failure (HF) training and are poorly integrated into the medical

Summary

Introduction

Home care workers (HCWs), which include home health and personal care aides, represent one of the fastest growing sectors of the healthcare industry and US economy [1]. HCWs are integral to home healthcare delivery, often assisting patients with personal care, activities of daily living, and serving as minute-to-minute observers of patients’ health [3, 4]. As such, they have the opportunity to respond to and triage patients’ symptoms, which can directly influence patient behavior and outcomes. In HF, HCWs prepare low salt meals, monitor weight and blood pressure, offer medication reminders, and assist with doctors’ appointments Despite this level of involvement, the majority of HCWs have not received HF training, which can impede their ability to recognize and triage patients’ symptoms [6]. While some trips are clinically necessary, others could be avoided if HCWs were better supported in the field [7]

Methods

Discussion

Conclusion