MyPath to Home Web-Based Application for the Geriatric Rehabilitation Program at Bruyère Continuing Care: User-Centered Design and Feasibility Testing Study.

Chantal Backman,Anne Harley,Jay Mercer,Craig Kuziemsky,Liam Peyton

doi:10.2196/18169

Chantal Backman, Anne Harley + Show 3 more

Open Access

https://doi.org/10.2196/18169

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Abstract

BackgroundWhen older adults return home from geriatric rehabilitation in a hospital, remembering the plethora of medical advice and medical instructions provided can be overwhelming for them and for their caregivers.ObjectiveThe overall objective was to develop and test the feasibility of a novel web-based application called MyPath to Home that can be used to manage the personalized needs of geriatric rehabilitation patients during their transition from the hospital to home.MethodsThis study involved (1) co-designing a patient- and clinician-tailored web-based application and (2) testing the feasibility of the application to manage the needs of geriatric rehabilitation patients when leaving the hospital. In phase 1, we followed a user-centered design process integrated with the modern agile software development methodology to iteratively co-design the application. The approach consisted of three cycles in which we engaged patients, caregivers, and clinicians to design a series of prototypes (cycles 1-3). In phase 2, we conducted a single-arm feasibility pilot test of MyPath to Home. Baseline and follow-up surveys, as well as select semistructured interviews were conducted.ResultsIn phase 1, semistructured interviews and talk-aloud sessions were conducted with patients/caregivers (n=5) and clinicians (n=17) to design the application. In phase 2, patients (n=30), caregivers (n=18), and clinicians (n=20) received access to use the application. Patients and their caregivers were asked to complete baseline and follow-up surveys. A total of 91% (21/23) of patients would recommend this application to other patients. In addition, clinicians (n=6) and patients/caregivers (n=6) were interviewed to obtain further details on the value of the web-based application with respect to engaging patients and facilitating communication and sharing of information with the health care team.ConclusionsWe were successful at designing the MyPath to Home prototype for patients and their caregivers to engage with their clinicians during the transition from geriatric rehabilitation to home. Further work is needed to increase the uptake and usage by clinicians, and determine if this translates to meaningful changes in clinical and functional outcomes.International Registered Report Identifier (IRRID)RR2-10.2196/11031

Highlights

30,000 Canadians a year are admitted to the hospital with hip fractures [1]
We were successful at designing the MyPath to Home prototype for patients and their caregivers to engage with their clinicians during the transition from geriatric rehabilitation to home
This recommendation is consistent with findings that early access to an inpatient geriatric rehabilitation program after hip fracture increases the likelihood of patients returning home [5]

Summary

Introduction

30,000 Canadians a year are admitted to the hospital with hip fractures [1]. Best practice guidelines exist to ensure the quality of care of patients with hip fractures [3]. These guidelines recommend all patients with hip fractures receive active rehabilitation following their acute care stay, with rehabilitation beginning no later than 6 days following surgery [4]. This recommendation is consistent with findings that early access to an inpatient geriatric rehabilitation program after hip fracture increases the likelihood of patients returning home [5]. When older adults return home from geriatric rehabilitation in a hospital, remembering the plethora of medical advice and medical instructions provided can be overwhelming for them and for their caregivers

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