Taking the call-bell home: a qualitative evaluation of Tele-HomeCare for children

Authors

  • Nancy L. Young BScPT MSc PhD,

    1. The Hospital for Sick Children, Toronto, Ontario,
    2. Departments of Pediatrics and Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto,
    3. Department of Physical Therapy, University of Toronto,
    4. Health Care, Technology and Place, CIHR Strategic Training Program, University of Toronto, Toronto, Ontario, Canada,
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  • Wendy Barden BScPT MSc,

    1. The Hospital for Sick Children, Toronto, Ontario,
    2. Department of Physical Therapy, University of Toronto,
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  • Patricia McKeever BN MSc(A) PhD,

    1. Faculty of Nursing, University of Toronto,
    2. Health Care, Technology and Place, CIHR Strategic Training Program, University of Toronto, Toronto, Ontario, Canada,
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  • Paul T. Dick MDCM MSc,

    1. The Hospital for Sick Children, Toronto, Ontario,
    2. Departments of Pediatrics and Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto,
    3. Health Care, Technology and Place, CIHR Strategic Training Program, University of Toronto, Toronto, Ontario, Canada,
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  • The Tele-HomeCare Team

    1. The Tele-HomeCare Team includes Carolyn Daniels PhD, Marilyn Booth RN MHSc and Jennifer Bennie MA BA from the Hospital for Sick Children; Stacey Daub MA from the Toronto Community Care Access Centre; Teresa To PhD, Bonnie Stevens RN PhD and Robert Filler MD from the Hospital for Sick Children and University of Toronto; and Peter Coyte PhD from the Health Care, Technology and Place, CIHR Strategic Training Program at the University of Toronto
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Dr Nancy L. Young Community Health Systems Resource Group The Hospital for Sick Children 555 University Avenue Toronto, Ontario Canada M5G 1X8 E-mail: nancy.young@sickkids.ca

Abstract

Tele-HomeCare (THC) delivers health care at home using telephone technologies. A THC service was developed as an adjunct to existing hospital and community care systems. It connected healthcare providers to children and families at home, during the initial transition from hospital to home, using video-conferencing phones and remote vital signs monitors. The goal was to support the transition from hospital to home, for children with subacute healthcare needs. This paper reports the qualitative evaluation of THC and describes the experiences of families supported by THC. A total of 16 mothers, four fathers and two adolescents from 16 families participated in a series of interviews conducted before, during and after THC. The interviews focused on the impact of THC on the children, on the families, and on their overall healthcare experience. Analysis of their accounts identified three subthemes: the stable child, a sense of security, and the healthcare-proficient parent. These subthemes were consistent across all time points and participants. Together they contributed to the overall effect of THC: the timely reunification of the family at home. THC was consistently reported to be an important resource that supported children and families during the transition from hospital to home. The benefits to children and families observed in this study may have also been a consequence of returning to their home environment, since THC allowed these children to be discharged home at a much earlier period. However, our findings are consistent with previous reports of the benefits of THC. Thus, THC is a successful method of healthcare service delivery that enables a safe return home with professional support provided remotely.

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