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

Justine Giosa, Paul Holyoke, Danielle Bender, Sandra Tudge, Wendy Gifford


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.


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

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DOI: http://dx.doi.org/10.22230/jripe.2015v5n2a200