Telehealth practices are numerous. Although we spontaneously think of virtual meetings between a patient and a health professional, there are other ways of organizing virtual care such as remote assistance between professionals (teleassistance), case discussions via videoconference and the Telehomecare Monitoring Platform. One of the services offered is “Symptom Surveillance”, a technological platform that allows for the monitoring of symptoms associated with COVID-19 in order to reduce the risk of an outbreak of the virus. Since the winter of 2021, the team at the Blainville CHSLD of the CISSS des Laurentides has been successfully testing it with its residents.
With the Symptom Surveillance platform, the CHSLD’s orderlies are responsible for completing a daily questionnaire consisting of three main questions on COVID-19 symptoms for each resident of the nursing home. When a symptom compatible with COVID-19 appears, an alert is generated on the platform to inform the nurse that the user requires a more in-depth assessment. This protocol improves the quality and safety of the care and services provided to residents while ensuring the security and confidentiality of the data. The platform is accessible on the web from a computer, a tablet or even a smart phone. The Blainville CHSLD team has chosen to use iPads in their project.
From the beginning of the deployment of this service, the team opted for a participative and collaborative management. In this way, each micromilieu (housing sections grouping residents with similar profiles) was able to choose the ways to organize the work according to its reality. For example, choosing the time of day to monitor and how to assign residents to the team. Initially, some staff had concerns about introducing this new way of working: « At first the team was concerned that verbal communication would stop, but it did not. Also, the nursing assistants had the perception that their jobs were being taken away by the orderlies. Eventually, this feeling of threat resolved itself », says Kim Traversy, Unit Manager at the Blainville CHSLD.
Orderlies appreciated their involvement in care coordination, although the pace of adjustment to change was different for each. For example, some feared that their lack of technological knowledge would be a barrier. However, it turned out that the orderlies and nurses found the platform intuitive and easy to use: « The interface is very easy to understand, the visuals are well done, very clean. So even the most reluctant orderlies are now the most assiduous» mentions Françis Lebel, orderly. As for the perception that this tool would lead to a decrease in verbal exchanges, it was found instead that Symptom Surveillance had the effect of improving the fluidity, safety and speed of communications. Teams also reported gains in terms of teamwork structure and traceability of clinical data, i.e., where and when information was reported.
In the end, this experience proved to be very positive and opened the door to the integration of the technology in other processes of the CHSLD. Thus, other applications of the technological platform used for COVID-19 Symptom Surveillance have been tested and could be tried out in other CHSLDs. These include early detection of changes in the condition of the user being cared for. M. Lebel concludes: « Personally, I find it to be an added value! It’s a great tool for the orderlies, the nursing assistants, the nurses and especially for the well-being of our residents. I can’t wait to see how the platform will evolve and what other tools will be integrated into it ». Let’s hope that the inspiring experience of the Blainville CHSLD will serve as a model for other residential centers in the network. One thing is certain: the Réseau québécois de la télésanté is there to support care teams and institutions in the implementation of various virtual care tools.
The benefits of using the COVID-19 Symptom Surveillance protocol, in brief:
- Increase in the speed of information transmission;
- Improved security of transmitted information (avoids human communication errors);
- Improved working structure for symptom monitoring;
- Intuitive and easy-to-use technology tool for all, including novices;
- Increased quality and safety of care and services and ultimately;
- Reduced risk of virus outbreak.
For more information on the Symptom Surveillance tool, see the following pages: