Patient Rounds With Video-Consulted Relatives: Qualitative Study on Possibilities and Barriers From the Perspective of Healthcare Providers.

Christina Østervang,Dorthe Boe Danbjørg,Lene Vedel Vestergaard,Karin Brochstedt Dieperink

doi:10.2196/12584

Abstract

BackgroundIn cancer settings, relatives are often seen as a resource as they are able to support the patient and remember information during hospitalization. However, geographic distance to hospitals, work, and family obligations are reasons that may cause difficulties for relatives’ physical participation during hospitalization. This provided inspiration to uncover the possibility of telehealth care in connection with enabling participation by relatives during patient rounds. Telehealth is used advantageously in health care systems but is also at risk of failing during the implementation process because of, for instance, health care professionals’ resistance to change. Research on the implications for health care professionals in involving relatives’ participation through virtual presence during patient rounds is limited.ObjectiveThis study aimed to investigate health care professionals’ experiences in using and implementing technology to involve relatives during video-consulted patient rounds.MethodsThe design was a qualitative approach. Methods used were focus group interviews, short open interviews, and field observations of health care professionals working at a cancer department. The text material was analyzed using interpretative phenomenological analysis.ResultsField observational studies were conducted for 15 days, yielding 75 hours of observation. A total of 14 sessions of video-consulted patient rounds were observed and 15 pages of field notes written, along with 8 short open interviews with physicians, nurses, and staff from management. Moreover, 2 focus group interviews with 9 health care professionals were conducted.Health care professionals experienced the use of technology as a way to facilitate involvement of the patient’s relatives, without them being physically present. Moreover, it raised questions about whether this way of conducting patient rounds could address the needs of both the patients and the relatives. Time, culture, and change of work routines were found to be the major barriers when implementing new technology involving relatives.ConclusionsThis study identified a double change by introducing both new technology and virtual participation by relatives at the same time. The change had consequences on health care professionals’ work routines with regard to work load, culture, and organization because of the complexity in health care systems.

Highlights

BackgroundWhen a patient receives a cancer diagnosis, it will affect the patient and the entire family surrounding the patient [1,2]
This study identified a double change by introducing both new technology and virtual participation by relatives at the same time
One of this study’s main findings was health care professionals agreeing on the positive impact of relatives participating in the patient rounds, which they experienced as a qualification of the conversation

Summary

Introduction

BackgroundWhen a patient receives a cancer diagnosis, it will affect the patient and the entire family surrounding the patient [1,2]. Work, family obligations, and distance to the hospital are reasons that cause difficulties for relatives to be present at the hospital and complicate their participation in patient rounds [11,13]. Rising et al found that by using videoconferencing platforms, health care professionals were able to facilitate relative’s participation during patient rounds remotely [11] This inspired us to look at the possibilities that telehealth care provides to enable increased relative participation for hospitalized patients. Geographic distance to hospitals, work, and family obligations are reasons that may cause difficulties for relatives’ physical participation during hospitalization This provided inspiration to uncover the possibility of telehealth care in connection with enabling participation by relatives during patient rounds. Research on the implications for health care professionals in involving relatives’ participation through virtual presence during patient rounds is limited

Methods

Results

Discussion

Conclusion