Observe, Coach, Assist, and Report: An Emerging Framework for Integrating Unregulated Healthcare Providers into Interdisciplinary Healthcare Teams

Authors

Justine Giosa Saint Elizabeth University of Waterloo
Paul Holyoke Saint Elizabeth
Danielle Bender Saint Elizabeth
Sandra Tudge Saint Elizabeth
Wendy Gifford Saint Elizabeth University of Ottawa

DOI:

https://doi.org/10.22230/jripe.2015v5n2a200

Keywords:

Personal support worker, Unregulated healthcare provider, Interdisciplinary, Homecare, Rehabilitation

Abstract

Background: Unregulated healthcare providers known as personal support workers (PSWs) provide the majority of home care services in Ontario, Canada. However, there is little direction to guide their activities as members of interdisciplinary healthcare teams. The purpose of this study was to explore and describe the role of PSWs in interdisciplinary evidence-based stroke care.

Methods and Findings: A concurrent triangulation mixed-methods design was used. Data sources included surveys (N = 270), chart audits (N = 234), interviews (N = 28), focus groups (N = 7), textbook review, an advisory committee (N = 14), and knowledge fairs (N = 112). PSWs can participate in team-based stroke care by observing vital information about clients in their homes, coaching clients to follow care plans, assisting to implement recommendations made by other healthcare providers, and reporting client progress, challenges, needs, and preferences to the healthcare team.

Conclusions: The Observe, Coach, Assist, and Report (OCAR) themes have the potential to be used as a framework to guide improvements in intra-team communication, information sharing, and awareness of the PSW role, in order to support a more integrated home care experience for clients and families. Next steps include pilot testing the OCAR framework at the point of care in various settings to enhance interdisciplinary collaboration that is inclusive of PSWs.

Author Biographies

Justine Giosa, Saint Elizabeth University of Waterloo

Justine has been working as a health services researcher for five years. Her research areas include family caregiving, stroke, the role of personal support workers and seniors care. Justine has a BSc in Biology and Psychology and a MSc in Health Studies and Gerontology. She currently works as a Research Associate at Saint Elizabeth and is a PhD student at the University of Waterloo in the School of Public Health and Health Systems. Her doctoral research focuses on the development of a more integrated geriatric care planning and delivery approach for home care service providers.

Contribution: Co-investigator on the study; participated in the study design; led the ethics application process; co-led the ADAPTE process with Paul Holyoke; completed the textbook reviews; participated in the literature review of studies supporting the CSS-BPRs; participated in the analysis leading to the OCAR framework and barriers to implementation themes; conceived, coordinated, and participated in the knowledge fairs; and drafted the manuscript; read and approved the final manuscript.

Paul Holyoke, Saint Elizabeth

Paul Holyoke, Director of Saint Elizabeth Research Centre, has an extensive applied research portfolio across four themes: person and family centred care, end of life care, caregivers, and integrated care. He has a Ph.D. in Health Policy from the University of Toronto, a M.Sc.(Econ) from LSE and a law degree.

Contribution: conceived of the study; was a co-principal investigator; participated in the study design; co-led the ADAPTE process with Giosa; led the public consultation process; participated in the analysis leading to the OCAR framework and barriers to implementation themes; participated in the knowledge fairs; and helped to draft the manuscript; read and approved the final manuscript.

Danielle Bender, Saint Elizabeth

Danielle has ten years of experience as a researcher in both the private and public sector. In her current position as Research Associate, Danielle performs various research activities such as literature and jurisdictional reviews, program evaluations, project management, knowledge translation and exchange, the development of research proposals and primary data collection through surveys, interviews and focus groups. Danielle is also leading research related to person-centred care (PCC) and developing, implementing and evaluate PCC education programs for all levels of the organization. Danielle has an M.A. in Criminology and an Honours B.A. in Psychology from York University.

Contribution: was a co-investigator on the study; participated in the study design; helped with the ethics application; carried out the chart audits and PSW surveys with Tudge; coordinated research team meetings; conducted key informant interviews; participated in the analysis leading to the OCAR framework and barriers to implementation themes; coordinated and participated in the knowledge fairs; and helped to draft the manuscript; read and approved the final manuscript.

Sandra Tudge, Saint Elizabeth

Sandra has worked at Saint Elizabeth for over 10 years. Her primary research interests include mental health and psychogeriatrics. Sandra holds an Honours Bachelor of Arts (Psychology) from the University of Waterloo and a Masters of Social Work from the University of Toronto focusing on social welfare, and program and policy development. Prior to coming to Saint Elizabeth, Sandra worked at the Ontario Division of the Canadian Mental Health Association as a Community Mental Health Consultant providing support to local communities in strategic planning, board development, advocacy, and policy and program development and evaluation in mental health and housing.

Contribution: was a co-investigator on the study; participated in the study design; helped with the ethics application; carried out the chart audits and PSW surveys with Bender; conducted key informant interviews; coordinated the study advisory committee; participated in the analysis leading to the OCAR framework and barriers to implementation themes; coordinated and participated in the knowledge fairs; and helped to draft the manuscript; read and approved the final manuscript.

Wendy Gifford, Saint Elizabeth University of Ottawa

Wendy was appointed a joint position in May, 2011 as Senior Research Associate at Saint Elizabeth and Assistant Professor at University of Ottawa Faculty of Health Sciences. She completed a PhD from the University of Ottawa in 2011. Her research program focuses on leadership and knowledge translation, specifically leadership for the implementation of nursing best practice guidelines to improve patient outcomes and nursing service delivery. Prior to entering academia, Wendy had an extensive clinical nursing career that included outpost nursing in Canada’s Aboriginal communities, community program development for high risk pregnant teenagers, and Emergency Room and Intensive Care Unit nursing.

Contribution: was a co-principal investigator of the study;

participated in the study design; participated in the analysis leading to the OCAR framework; participated in the knowledge fairs; and helped to draft the manuscript; read and approved the final manuscript.

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Published

2015-10-21

Issue

Vol. 5 No. 2 (2015)

Section

Articles: Empirical Research

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