Grant: Travel Awards - Institute Community Support

Objectives: This project involved the design and implementation of an innovative electronic (tablet-based) tool for use by hospital-based palliative care clinicians to assess the quality of life concerns of patients and their family caregivers. The goals of the project were to: 1) collaborate with clinicians, patients and family members to inform the design and integration of the QPSS into routine clinical practice, and 2) examine the implementation process and outcomes of using of the QPSS. Methods: This knowledge-to-action research project involved palliative clinicians, researchers, patients and caregivers in Western Canada. User-centered design of the QPSS was informed by five focus groups with clinicians, and implementation evaluated by direct observation and interviews with clinicians (n = 19), patients (n = 4) and family caregivers (n = 5). Interpretive description was used as a general approach to qualitative analysis. Results: Patients and family caregivers found the QPSS user friendly, and responded favourably to its use. Focus groups and interviews with clinicians drew attention to the need to pay attention to organizational context, previous experience with using quality of life assessments, and patterns of interdisciplinary communication and workflow. Clinicians also expressed the need for immediate benefits to workload when using the system, and a desire for ongoing educational supports. Conclusion: Integration of new technology requires long-term capacity building through: 1) educational initiatives to support practice change, 2) addressing existing beliefs and behaviour patterns regarding the use of technology and standardized assessments, and 3) attention to organizational contexts including existing data systems and workload.