Can microblogging be used to improve the richness and quality of care notes made by care staff?
In our research project MIRROR we are working with the Registered Nursing Homes Association (RNHA) to support the capture of more reflective observations by care staff through the use of microblogging tool to improve sharing of work relevant information and collaborative work as well as improving the data capture processes for information about a residents daily activities, health, mental health and needs.
Carers already make notes about the care they deliver, the health and the mental status of the residents in their care. This is often still done entirely on paper. Only a minority of care homes currently use digital care plans, and where these are implemented there are usually only one or two computers available for carers to use to enter their notes – resulting in a queue to type up their notes at the end of each shift. Not exactly ideal for encouraging rich care notes. Also, in their current form, the care notes are not easy to review and it can be difficult to identify a very gradual change in a resident’s condition which may occur over a longer period.
So in MIRROR, we are planning to use mobile devices running apps that enable care staff to record information about care in situ at the time that it is generated. As a proof of concept we ran a 3 day trial using protected Twitter accounts and the free Twitter App running on an Apple iPod Touch locked to provide only the capabilities needed by care staff during a shift.
Unlike regular tweets that can be followed by members of the public, the observations captured could only be accessed by the other devices being used by care staff and the shift supervisor who monitored the tweets throughout the shift. And unlike the current process with paper notes, each observation was shared in real-time, which increased communication between the care staff in the residential home.
For the next phase we are implementing an enterprise microblogging tool called Yammer. Unlike Twitter, which is designed to be a tool to broadcast public posts that can be accessed by anyone on the web, Yammer is designed to be used internally within an organisation and is accessible only to members of that organisation. This provides a closed, encrypted network where carers can post observations and care notes for their residents. These posts will be monitored by the shift supervisor for patterns in resident behaviour and changes in mental or physical condition. The posts will also be incorporated into a daily or weekly summary for each resident, which the nurses and senior carers can use to track changes over time and to input into revisions of care plan for each resident.
We’ll be trialling this later this year, and we’ll keep you posted. We’d love to hear from you about your experience using micro-blogging tools in an organisational context.
Author: Kristine Pitts