Isla for Frailty Feasibility Study
Research type
Research Study
Full title
Acceptability, feasibility, and potential effectiveness of video-based patient records for supporting care delivery for older people with frailty.
IRAS ID
313814
Contact name
Phoebe Averill
Contact email
Sponsor organisation
Imperial College Healthcare NHS Trust
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 4 months, 27 days
Research summary
Research Summary
BACKGROUND: Frailty is a state of increased vulnerability due to a decline in the body’s reserves. Older people with frailty struggle to bounce back after illness or stressful events such as being in hospital. Evidence is clear that these patients benefit from comprehensive assessment and coordinated care. However, ineffective communication between care-providers means assessments are often repeated, and patients and carers become frustrated at being asked the same questions by different professionals. It is often difficult for professionals to build up a complete picture solely from written information in medical records. Healthcare professionals need to understand a person’s functional abilities and support needs (e.g. mobility/assistance required). Smartphones with cameras are now commonplace, and people often tell their stories using photographs/videos. We believe that video-recordings could help with recognising changes in an individual’s day-to-day functioning, delivering better personalised care and communicating support needs. However, we don’t know how patients and carers feel about being video-recorded or whether patient videos will improve care.
AIM: To explore the perspectives of frail older patients, carers, and clinical staff of embedding in the electronic patient record, the video-recordings of patients captured during routine clinical care, and to understand how patient videos could impact on care delivery across care transitions.
METHODS: We will recruit frail, older inpatients, their carers, and clinical staff from a Medicine for the Elderly ward, and clinical stakeholders across an Integrated Care System. Over three months, doctors/nurses/therapists will securely record and view patient videos alongside providing usual care. Videos will capture patients’ functional abilities and support needs to inform ongoing assessment and care. We will collect information from patients/carers/doctors/nurses/therapists about their experiences of the video-recording intervention.Summary of Results
Overall, our findings suggested that using video-recordings as part of the assessment and care of patients was acceptable to study participants, including older patients with frailty, family/carers, and clinical staff. This was measured in a range of ways. Participant recruitment and retention rates for patients were promising: 29/51 eligible patients were enrolled (56.9%), of whom one patient withdrew due to changing their mind about their wish to take part. Ward staff recruitment exceeded aims (58 staff recruited, versus initial aims of recruiting 35 staff members); participants represented the full range of clinical professional groups on the wards, such as doctors, nurses, and therapies professionals. Ward staff were able to identify multiple potentially valuable use cases for patient videos, including documenting seizures or a person's support needs. Interview data from patients, carers, and clinical staff suggested that participants considered the intervention to be acceptable, on the basis that potential ethical issues were mitigated (e.g. patient dignity, information security considerations).
We also found that video-based patient records are feasible to implement within acute wards for older adults. However, a number of barriers to successful implementation were discussed by participants. These included issues with short staffing, environmental factors in the busy ward setting, and insufficient prompting and reminders to use the intervention. Overall, data showing the number of video views by staff suggests that there was low usage of video-recordings by staff once captured.
Finally, participants spoke about a range of ways in which video-based patient records might be beneficial as part of patient assessment and care. For example, participants felt that patient videos could improve communication practices in the future between staff members about a patient's condition. They also believed that using the intervention may help ward staff to deliver more person-centred care. Further research would be required to determine whether the intervention is effective in practice.
REC name
South Central - Oxford C Research Ethics Committee
REC reference
23/SC/0167
Date of REC Opinion
5 Jul 2023
REC opinion
Further Information Favourable Opinion