Howz have completed a trial in Salford to establish whether monitoring older people's daily routine helps them feel better living in the community after being discharged from hospital
Howz for Health
A study of remote monitoring at discharge
Introduction
A study has been conducted in order to establish whether monitoring older people's daily routine could help them to feel better about living in the community after being discharged from hospital.
A key focus of the study was how this type of service could be used to improve the care provided by an NHS clinical service or Social Care Service.
The study was carried out with the deployment of an easy-to-install sensor kit placed in homes of study participants after their hospital discharge.
Who was asked to participate?
The identification of suitable study participants was led by the Northern Care Alliance therapy team at the Bevan Unit at Salford Royal Hospital, and Bridgewater Care Home.
These teams selected people who matched criteria as being suitable for the trial and asked them if they were interested in participating.
The trial included people who were over 55 years of age, were classified as moderately frail, were going to return to home alone or with one other person, and were able to give their consent to participate.
Each participant that consented was also asked if they would be happy to include a carer or family member who was in turn asked for their consent to participate.
The project recruited 23 participants to the trial, but only 17 went onto the full installation due to changes in their circumstances.
The average age of participants was 77 with 30% male and 70% female.
The main concerns of participants at discharge were:
History of falls 62%
Shortness of breath 23%
Pain 23%
Reduced mobility 85%
What happened in the trial?
Soon after discharge back to home from hospital, a researcher visited the participant, installed the sensors, and completed a set of questions with the participant and the carer.
After installation of the kit the carer had access to an app on their smartphone that illustrated the activity from the sensors and alerted them if there were any unexpected changes.
Each week the researcher contacted the participant to check on their wellbeing and confirm their routine over the last week.
These routine checks included things like the time they go to bed, the time they get up, and their level of activity in the day and night. Checks of indicators allowed the research team to identify if there had been any changes in routine or events relating to health that week.
After the initial six weeks following discharge, the questions asked in these routine checks were repeated, and again after 12 weeks when the trial ended.
At week 12 the equipment was removed from the participant’s home, and the participant and their carer were interviewed to gather their feedback on the product. Some of the participants opted to keep the equipment at the end of the trial.
At the end of the trial, staff in the community and at the hospital attended a workshop where they shared their views on the product and checked the findings with their records for the individual participant.
What were the results?
Information from the remote monitoring system regarding daily routine showed strong similarity with self reported routine when checked via the weekly research calls.
Participants reported that they did not find these weekly research calls a burden.
During research interviews, most participants reported that they forgot the sensors were in their home during day to day life. There was some increased awareness initially but this soon settled
All participants stated that they felt there was a potential benefit for monitoring of routine
All participants stated that the service had little impact on their day to day life
For those with carers who participated there was generally a feeling that there was a benefit to monitoring routine
For carers living apart from the participant there was agreement that it helped reduce their anxiety and it was a very valuable service
For a few participants 4 out of 17 there were significant events that were detected by the system and it helped the relatives to deal with the situation
Staff feedback suggested that information from the sensors was accurate and matched their understanding of the situation for the individual participants
Staff were supportive of the use of sensors as part of the discharge pathway, but felt that work was needed to increase the detail from the home and to understand who would be monitoring this information as part of normal services.
What were the conclusions and recommendations?
It was concluded that the use of the Howz product was feasible at discharge from hospital for older people.
It was concluded that people found the product acceptable to use in their home, that the information provided was correct, and that carers found the app with the product helpful.
It was recommended that in future more sensors would be helpful to provide more detail about the routine.
It was recommended that a larger project would be helpful to test the product further and understand the benefits for patients and their families as well as the broader system.
