Implementation of Assistive Technologies and Robotics in Long-Term Care Facilities: A Three-Stage Assessment Based on Acceptance, Ethics, and Emotions

Beyond Plan-Do-Study-Act cycle - staff perceptions on facilitators and barriers to the implementation of telepresence robots in long-term care

BACKGROUND

Quality improvement (QI) programs with technology implementations have been introduced to long-term care (LTC) to improve residents' quality of life. Plan-Do-Study-Act (PDSA) cycle is commonly adopted in QI projects. There should be an appropriate investment of resources to enhance learning from iterative PDSA cycles. Recently, scholars explored possibilities of implementation science (IS) with QI methods to increase QI projects' generalisability and make them more widely applicable in other healthcare contexts. To date, scant examples demonstrate the complementary use of the two methods in QI projects involving technology implementation. This qualitative study explores staff and leadership teams' perspectives on facilitators and barriers of a QI project to implement telepresence robots in LTC guided by the Consolidated Framework for Implementation Research (CFIR).

METHODS

We employed purposive and snowballing methods to recruit 22 participants from two LTC in British Columbia, Canada: operational and unit leaders and interdisciplinary staff, including nursing staff, care aides, and allied health practitioners. CFIR was used to guide data collection and analysis. Semi-structured interviews and focus groups were conducted through in-person and virtual meetings. Thematic analysis was employed to generate insights into participants' perspectives.

RESULTS

Our analysis identified three themes: (a) The essential needs for family-resident connections, (b) Meaningful engagement builds partnership, and (c) Training and timely support gives confidence. Based on the findings and CFIR guidance, we demonstrate how to plan strategies in upcoming PDSA cycles and offer an easy-to-use tool 'START' to encourage the practical application of evidence-based strategies in technology implementation: Share benefits and failures; Tailor planning with staff partners; Acknowledge staff concerns; Recruit opinion leaders early; and Target residents' needs.

CONCLUSIONS

Our study offers pragmatic insights into the complementary application of CFIR with PDSA methods in QI projects on implementing technologies in LTC. Healthcare leaders should consider evidence-based strategies in implementing innovations beyond PDSA cycles.

Dances with Social Robots: A Pilot Study at Long-Term Care

Dance therapy can have significant physical, emotional and cognitive benefits for older adults. In particular, social robots can be developed to autonomously facilitate dance sessions to engage these individuals with the aim of improving quality of life. To successfully integrate and promote long-term use of social robots into long-term care homes for such recreational activities, it is important to explore both residents’ and staff’s perceptions of such robots. In this paper, we present the first pilot human–robot interaction study that investigates the overall experiences and attitudes of both residents and staff in a long-term care home for robot-facilitated dance sessions. In general, the questionnaire results from our study showed that both staff and residents had positive attitudes towards the robot-facilitated dance activity. Encouraging trends showed residents had higher ratings for statements on perceived ease of use, safety, and enjoyment than the staff. However, the staff had a statistically significantly higher rating for willingness to use the robots for dance facilitation. Some key statistical differences were also determined with respect to: (1) gender within the resident group (men had higher ratings for the robots being useful in helping facilitate recreational activities), as well as between staff and residents (resident men had higher perceived safety), and (2) prior robot experience (residents with limited prior experience had higher ratings on perceived ease of use and perceived enjoyment than staff with the same level of experience). The robot-facilitated dance activity was positively received by both older adults and staff as an activity of daily living that can enhance wellbeing while also being safe, easy to use and enjoyable.