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Supporting and improving community health services—a prospective evaluation of ECHO technology in community palliative care nursing teams
  1. Clare White1,
  2. Sonja McIlfatrick2,
  3. Lynn Dunwoody3 and
  4. Max Watson1
  1. 1N. Ireland Hospice, Belfast, Northern Ireland
  2. 2Institute of Nursing and Health Research, Ulster University, Newtownabbey, Northern Ireland
  3. 3School of Psychology, Ulster University, Coleraine, Northern Ireland
  1. Correspondence to Dr Clare White, N. Ireland Hospice, Whiteabbey Hospital Site, Doagh Rd, Newtownabbey, Belfast BT37 9RH, Northern Ireland

Abstract

Introduction Project ECHO (Extension for Community Healthcare Outcomes) uses teleconferencing technology to support and train healthcare providers (HCPs) remotely, and has improved care across the USA. A 6-month pilot was trialled in a community palliative care nursing setting to determine if ECHO would be effective in the UK in providing education and support to community hospice nurses (CHN).

Methods The pilot involved weekly 2 hour sessions of teaching and case-based discussions facilitated by hospice staff linking with nine teams of CHN using video conferencing technology. A mixed-methods prospective longitudinal cohort study was used to evaluate the pilot. Each CHN provided demographic data, and completed a written knowledge assessment and a self-efficacy tool before and after the pilot. Two focus groups were also performed after the pilot.

Results 28 CHNs completed the evaluation. Mean knowledge score improved significantly from 71.3% to 82.7% (p=0.0005) as did overall self-efficacy scores following the ECHO pilot. Pre-ECHO (p=0.036) and Retro-Pretest ECHO (p=0.0005) self-efficacy were significantly lower than post-ECHO. There was no significant difference between Pretest and Retro-Pretest ECHO self-efficacy (p=0.063). 96% recorded gains in learning, and 90% felt that ECHO had improved the care they provided for patients. 83% would recommend ECHO to other HCPs. 70% stated the technology used in ECHO had given them access to education that would have been hard to access due to geography.

Conclusions This study supports the use of Project ECHO for CHNs in the UK by demonstrating how a 6-month pilot improved knowledge and self-efficacy. As a low-cost high-impact model, ECHO provides an affordable solution to addressing growing need.

  • Education and training
  • Home care
  • teleconferencing
  • innovative educational interventions
  • Project ECHO
  • evaluation-educational intervention
  • Received 14 May 2015.
  • Revision received 1 October 2015.
  • Accepted 15 November 2015.

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