What we did:

We worked with Health Innovation Manchester, care home providers accross Greater Manchester, and an industry partner Safe Steps Ltd to address some of the challenges being faced in terms of data and support for care homes during COVID-19 and beyond.

 

 

Why is it important?

A digital tool for falls prevention in care homes had been adopted for roll-out at scale across Greater Manchester pre-COVID-19. This tool was adapted to collect resident data on COVID-19 symptoms as well as other key indicators including delirium. The Digital Care Homes C19 tracker summarised care home residents’ status in a dashboard that provides critical information to care home staff, community response teams, locality hubs, and primary care, supporting timely management. The COVID-19 tracker data was combined with data on staffing levels, residency occupancy levels and personal protective equipment (PPE) availability to create a single integrated COVID-19 dashboard.

 

It was envisaged that deployment of this tool would offer an immediate, potential, tactical solution to some of the challenges being faced in terms of data and support for care homes, and enabled the transition of care under COVID-19 from crisis to “business-as-usual” and with potential longer-term strategic benefits for care homes, their residents and the wider system (service as well as research benefits) via a detailed understanding of the barriers and facilitators to digital technologies adoption.

 

 

How we did it:

The evaluation was a mixed methods study:

 

• The quantitative evaluation - included description of care homes using/not using the COVID-19 tracker; description of data entry/completeness from user care homes; cost-consequences analyses and a controlled before-and-after study exploring COVID-19 tracker tool use versus reduced or increased COVID-19 incidence.

• The qualitative evaluation - aimed to describe the impact of the COVID-19 tracker on decision-making in the GM health and care system, its impact on care processes and resident and population outcomes, and describe the perceptions of key stakeholders in relation to the adoption, implementation and potentially wider roll-out of thetracker tool.

 

 

What we found:

Our evaluation found that:

 

• The use of the COVID-19 symptom tracker in care homes was not maintained, except in one locality
• Tracker use decreased over time, and at different rates in different localities, with average use (proportion of residents assessed with the tool) ranging between 18% and 58%.
• Use of the tracker did not appear to reduce the spread of COVID-19.
• The number of COVID-19 cases in care homes was mainly driven by the prevalence of COVID-19 in the area around the care home and rates of infection among staff members.
• The local context differed between localities and the process of implementation changed from the initial strategy over time in terms of stakeholder engagement and training for care homes.

 

We found a number of key factors influenced the uptake and use of the tracker by care home staff and clinicians:

 

• The way the COVID-19 tracker was implemented in each locality, in terms of piloting, training of care home staff and stakeholder engagement.
• Changes in the ways care homes worked during the pandemic and differences in the ways localities managed COVID-19 in care homes.
• The priority placed on using the tracker in the context of wider system pressures.

 

 

This work supports prior research on the implementation of e-health innovations to highlight that the future development and implementation of rapid digital responses in care home settings – even in times of crisis – could be informed by three key factors:

 

1. an incremental approach to implementation with testing of organisational readiness and attention to implementation climate;
2. involvement of end-users in innovation design and development; and
3. enabling users’ easy access to sustained, high-quality, appropriate training and support to enable staff to adapt to digital solutions.

 

The full evaluation report, the actionable findings document and the associated academic publications are available below.

 

 

Donwloadable resources:

• Publications
  • Nelson, P.A., Bradley, F., Ullah, A., Whitaker, W., Brunton L., Calovski, V., Money A., Dowding D., Cullum N., & Wilson, P., Implementation, uptake and use of a digital COVID-19 symptom tracker in English care homes in the coronavirus pandemic: a mixed-methods, multi-locality case study. Implementation Science Communications (2023).
  • Ullah, A., Whittaker, W., Bradley, F., Nelson P.A., Dowding, D., Morciano, M., & Cullum, N.,  The use and impact of digital COVID-19 tracking in adult social care: a prospective cohort study of care homes in Greater Manchester. BMC Infectious Diseases (2023)
• Reports
  • Digital Care Homes COVID-19 Symptom Tracker Evaluation Report (Published February 2023)
• News stories
  • New research published on the use of a Digital COVID-19 tracker in care homes across Greater Manchester (published March 2023)

 
Who we worked with:

• Health Innovation Manchester
• Safe Steps Ltd
• Care home providers accross Greater Manchester

 

 

More information:

 

 

Programme Manager

 

Dr Ross Atkinson