P07 - Developing a “Best Possible Caregiving History” for Use in a Geriatric Emergency Department

Background: Better discharge planning and care coordination could address many of the issues that present in a geriatric emergency department (ED; e.g., non-injurious falls, wandering behaviors), but this requires an understanding of a patient’s caregiving context to plan interventions. We thus sought to develop a method to standardize how we collect data on a patient’s caregiving context.

Methods: Using human-centered design, we are developing a process for collecting and displaying information about patient caregiving contexts, which we call the “best possible caregiving history” (BPCH). Using semi-structured interviews and focus groups, we queried key informants (ED social workers, geriatric nurses, physicians, and geriatricians) on what would be helpful for documenting caregiving contexts, ideated and developed several prototypes, and solicited feedback.

Results: From semi-structured interviews, major themes included preferences for organization by functional need, need for brief narrative with summarized information, and assessment of adequacy of caregiving. In feedback sessions, users wanted caregiving data to be systematized and organized but some struggled to see how the BPCH would be used and wondered who would collect the data. In response, we updated prototypes to mimic the local health record and iterated further on systematic BPCHs.

Conclusion: Human-centered design methods have helped us rapidly prototype and solicit feedback on a BPCH with potential users. Next prototypes will need to test systems for organizing caregiving data, test how to present when caregiving is insufficient and balance comprehensiveness with expedient data collection.