Rural and Remote Health (Apr 2021)
Improvement in palliative care quality in rural nursing homes through information and communication technology-driven interprofessional collaboration
Abstract
Introduction: Information and communication technology (ICT) can facilitate long-term care. In long-term care, effective communication among healthcare professionals is vital to reduce inappropriate emergency transfer and eventual death in hospitals. As nursing homes in rural areas lack adequate healthcare resources, ICT can reduce the burden on professionals, leading to adequate long-term care. This study investigated whether the application of ICT-based communication can reduce the number of emergency transportations to, and death in, hospitals in rural facilities. Methods: This was an interventional study. Participants were patients living in a rural nursing home in the westernmost part of Unnan City in Shimane prefecture, Japan. The intervention group was defined as patients living therein after application of the ICT system and the control group as patients living therein before application of the ICT system. The primary outcome was the rate of emergency transportation to hospitals and the secondary outcome was the rate of death in the nursing home. Results: The total number of participants was 96 (48 in the ICT usage group and 48 in the control group), and the average age of this sample was 89.5 years. The rate of emergency transportation was 54.2% (26/48) in the control group and 29.2% (14/48) in the intervention group (p=0.022). The rate of end-of-life care in the nursing home was 33.3% (3/9) in the control group and 84.6% (11/13) in the intervention group (p<0.001). Conclusion: ICT-driven nursing home care can reduce emergency transportation from nursing homes and enable patients in nursing homes to remain there longer, leading to an increase in end-of-life care in nursing homes, which provides hope to patients and their families. Therefore, these findings highlight that the continuous provision of ICT can facilitate end-of-life care in nursing homes.
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